John Michael Provenza, MD in Winston Salem, NC

John Michael Provenza, MD is a medicare enrolled "Internal Medicine - Gastroenterology" physician in Winston Salem, North Carolina. His current practice location is Medical Center Boulevard, Winston Salem, North Carolina. You can reach out to his office (for appointments etc.) via phone at (336) 713-7311.

John Michael Provenza is licensed to practice in North Carolina (license number 2023-01626) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508399346.

Contact Information

	John Michael Provenza, MD
	Medical Center Boulevard, Winston Salem, NC 27157-1900
	(336) 713-7311
	Not Available

Map and Direction

Physician's Profile

Full Name	John Michael Provenza
Gender	Male
Speciality	Internal Medicine - Gastroenterology
Location	Medical Center Boulevard, Winston Salem, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1508399346
Provider Enumeration Date: 04/08/2017
Last Update Date: 06/12/2023

Medicare PECOS Information:

PECOS PAC ID: 8224315049
Enrollment ID: I20230626000116

Medical Identifiers

Medical identifiers for John Michael Provenza such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508399346	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RG0100X	Internal Medicine - Gastroenterology	2023-01626 (North Carolina)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

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. John Michael Provenza allows following entities to bill medicare on his behalf.

Entity Name	Wake Forest University Health Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436

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. John Michael Provenza 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
John Michael Provenza, MD Medical Center Blvd, Winston Salem, NC 27157-0001 Ph: (336) 713-7777	John Michael Provenza, MD Medical Center Boulevard, Winston Salem, NC 27157-1900 Ph: (336) 713-7311

Reviews and Comments

Internal Medicine Doctors in Winston Salem, NC

Shannon Mitchell St Clair, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 186 Kimel Park Dr, Winston Salem, NC 27103 Phone: 336-277-2000 Fax: 336-277-2050
Dr. Kamal Hanee Henderson, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 186 Kimel Park Dr, Winston Salem, NC 27103 Phone: 336-277-2000 Fax: 336-277-2050
Dr. Michael Joseph Mccormack Jr., M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255
Randall Stephan Conrad, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-4305
Brooke Williams, DO Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-8383
Dr. Analicia Marie Alvarado, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255
Dr. David Defeo, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 3001 Lyndhurst Ave, Winston Salem, NC 27103 Phone: 336-765-0383 Fax: 336-768-1737

John Michael Provenza, MD - Medicare Internal Medicine in Winston Salem, NC