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Active NPI 1215948781 Individual Practitioner Female Practitioner

Jennifer A Prom , PA-C

Physician Assistant • Duluth, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jennifer Prom, PA-C is a certified Physician Assistant practicing in Duluth, MN. With approximately 21 years of clinical experience since completing medical education in 2005, Jennifer Prom delivers high-quality medical care to the local community at 619 W CENTRAL ENTRANCE.

Jennifer Prom is affiliated with St. Luke'S Hospital Of Duluth and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

619 W Central Entrance

Duluth, MN 558115448

Telephone 2182494987
Fax 2182494989
Associated Practice Facility / Clinic
🏢 St. Luke's Hospital Of Duluth Facility NPI 1053589259

Medicare Profile & Education

Medical School

Other

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Duluth, MN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
21 Yrs +11.5 yrs vs City Avg
City Avg: 9.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
180 Specialists

Practicing in Duluth, MN (4026 Statewide)

Telehealth Adoption Rate
16.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
36.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Prom (21 Years) 21 Yrs
Duluth Specialty Average (9.5 Years) 9.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
105 85 $86.81 $54.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
11 11 $45.45 $28.92

Medical Specialties & State Licenses

CMS Verified: 2020-12-16
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MN 10142

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License WI 4215

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
157938000 (MN)

Hospital & Practice Group Affiliations

St. Luke's Hospital Of Duluth

619 W Central Entrance, Duluth, MN 558115448

Phone: 2182494987

St. Luke's Hospital Of Duluth

1015 E 1st St, Duluth, MN 558052242

Phone: 2182497860

St. Luke's Hospital Of Duluth

1011 E 1st St, Duluth, MN 558052242

Phone: 2182497000

St. Luke's Hospital Of Duluth

4702 Grand Ave, Duluth, MN 558072742

Phone: 2182496800

Secondary Practice Locations

109 N 28th St E

Superior, WI 548806548

Phone: 7153953950

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Nichole Dorn , APRN

Nurse Practitioner - Family

NPI 1144658063

Advanced Practice Registered Nurse

Camille Ingle

Physician Assistant

NPI 1205227758
Amanda Leone , CNP

Nurse Practitioner - Family

NPI 1235771726

Certified Nurse Practitioner

Suzanne Anderson

Nurse Practitioner - Family

NPI 1386838712
Lori Lindgren , CFNP

Nurse Practitioner - Family

NPI 1508939042

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 16, 2020

Physician Assistant (License #4215 in WI)

NPI Profile Active January 30, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 30, 2017

Registered at 619 W CENTRAL ENTRANCE, DULUTH, MN 558115448 (Tel: 2182494987)

📍
Updated Business Mailing Address January 30, 2017

Registered at 619 W CENTRAL ENTRANCE, DULUTH, MN 558115448 (Tel: 2182494987)

👤
Provider Name / Credentials Updated January 30, 2017

Recorded as JENNIFER PROM, PAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2017

Physician Assistant (License #10142 in MN)

NPI Profile Active December 04, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location December 04, 2014

Registered at 915 E 1ST ST, DULUTH, MN 558052107 (Tel: 2182495555)

📍
Updated Business Mailing Address December 04, 2014

Registered at 915 E 1ST ST, DULUTH, MN 558052107 (Tel: 6512837464)

👤
Provider Name / Credentials Updated December 04, 2014

Recorded as JENNIFER PROM, PAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 04, 2014

Physician Assistant (License #10142 in MN)

🟢
Initial NPI Registration & Enumeration August 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215948781
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 10, 2006
Last Update: December 16, 2020
Sole Proprietor: No

Mailing Address

619 W Central Entrance

Duluth, MN 558115448

Phone: 2182494987

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.