Prohealth Select, Inc.
NPI 1417485053ActiveOrganization· Nurse Practitioner· Boca Raton, FL
Nurse Practitioner in Boca Raton, Florida, registered in NPPES in May 2017. The authorized official on file is Nancy Bourg, Ceo.
Overview
| NPI | 1417485053 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 26, 2017 |
| Last updated in NPPES | Jul 21, 2022 |
| Certified by provider | Sep 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | FL |
| Clinic/Center | 261Q00000X | — | — |
| Physician Assistant | 363A00000X | — | FL |
| Physician Assistant, Medical | 363AM0700X | — | — |
| Physician Assistant, Surgical | 363AS0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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