Joseph Johnny Provenzano Jr, DO in Modesto, CA

Joseph Johnny Provenzano Jr, DO is a medicare enrolled "Family Medicine" physician in Modesto, California. He graduated from medical school in 1983 and has 41 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Sutter Valley Medical Foundation and his current practice location is 3612 Dale Rd, Modesto, California. You can reach out to his office (for appointments etc.) via phone at (209) 522-0146.

Joseph Johnny Provenzano Jr is licensed to practice in California (license number 20A5427) 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 1215993738.

Contact Information

	Joseph Johnny Provenzano Jr, DO
	3612 Dale Rd, Modesto, CA 95356-0500
	(209) 522-0146
	Not Available

Map and Direction

Physician's Profile

Full Name	Joseph Johnny Provenzano Jr
Gender	Male
Speciality	Family Practice
Experience	41 Years
Location	3612 Dale Rd, Modesto, California
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:

Joseph Johnny Provenzano Jr graduated from medical school in 1983

NPI Data:

NPI Number: 1215993738
Provider Enumeration Date: 04/24/2006
Last Update Date: 06/11/2019

Medicare PECOS Information:

PECOS PAC ID: 1456416239
Enrollment ID: I20090210000825

Medical Identifiers

Medical identifiers for Joseph Johnny Provenzano Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215993738	NPI	-	NPPES
00AX54270	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	20A5427 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Medical Center	Modesto, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sutter Valley Medical Foundation	9830094515	1919

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. Joseph Johnny Provenzano Jr allows following entities to bill medicare on his behalf.

Entity Name	Sutter Valley Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669846986 PECOS PAC ID: 9830094515 Enrollment ID: O20090311000335

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. Joseph Johnny Provenzano Jr 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
Joseph Johnny Provenzano Jr, DO 10470 Old Placerville Rd Ste 100, Sacramento, CA 95827-2539 Ph: (800) 470-0071	Joseph Johnny Provenzano Jr, DO 3612 Dale Rd, Modesto, CA 95356-0500 Ph: (209) 522-0146

Reviews and Comments

Family Medicine Doctors in Modesto, CA

Dr. Chun Joey Chang, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Paradise Rd, #e, Modesto, CA 95351 Phone: 209-558-5107
Cyrus M Rabii, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-521-6097
Van Dinh, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1441 Florida Ave, Modesto, CA 95350 Phone: 209-573-6147 Fax: 209-573-6185
Dang Cong Nguyen, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Paradise Rd Ste E, Modesto, CA 95351 Phone: 209-558-4000
Irfan Haider, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1400 Florida Ave, Ste 102, Modesto, CA 95350 Phone: 925-444-5554 Fax: 925-281-3063
Gustavo M Galeano, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3612 Dale Rd, Modesto, CA 95356 Phone: 209-522-0146
Giang Ngoc Lam, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1541 Florida Ave, Suite 200, Modesto, CA 95350 Phone: 209-577-3388 Fax: 209-523-0764

Joseph Johnny Provenzano Jr, DO - Medicare Family Practice in Modesto, CA