Brett Allen Provence, DO is a medicare enrolled "Hospitalist" physician in Baldwin Park, California. He graduated from medical school in 2008 and has 16 years of diverse experience with area of expertise as Hospitalist. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is
1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, California. You can reach out to his office (for appointments etc.) via phone at
(626) 851-1011.
Brett Allen Provence is licensed to practice in California (license number 20A11220) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1003048026.
Physician's Profile
Full Name | Brett Allen Provence |
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Gender | Male |
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Speciality | Hospitalist |
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Experience | 16 Years |
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Location | 1011 Baldwin Park Blvd, Baldwin Park, California |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Brett Allen Provence graduated from medical school in 2008
NPI Data:
- NPI Number: 1003048026
- Provider Enumeration Date: 08/10/2009
- Last Update Date: 12/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 0143498543
- Enrollment ID: I20110728000521
Medical Identifiers
Medical identifiers for Brett Allen Provence such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1003048026 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208M00000X | Hospitalist | 20A11220 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Southern California Permanente Medical Group | 6002729175 | 8172 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brett Allen Provence allows following entities to bill medicare on his behalf.
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
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Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brett Allen Provence is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Brett Allen Provence, DO 1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, CA 91706-5806 Ph: (626) 851-1011 | Brett Allen Provence, DO 1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, CA 91706-5806 Ph: (626) 851-1011 |
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