Matthew J Provenzano, MD in Michigan City, IN

Matthew J Provenzano, MD is a medicare enrolled "Otolaryngology - Pediatric Otolaryngology" physician in Michigan City, Indiana. He went to Johns Hopkins University School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Franciscan Physician Network and his current practice location is 1225 E Coolspring Ave Ste 300, Michigan City, Indiana. You can reach out to his office (for appointments etc.) via phone at (219) 878-5032.

Matthew J Provenzano is licensed to practice in Indiana (license number 01072216A) 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 1639388911.

Contact Information

	Matthew J Provenzano, MD
	1225 E Coolspring Ave Ste 300, Michigan City, IN 46360-6312
	(219) 878-5032
	(219) 861-8151

Map and Direction

Physician's Profile

Full Name	Matthew J Provenzano
Gender	Male
Speciality	Otolaryngology
Experience	20 Years
Location	1225 E Coolspring Ave Ste 300, Michigan City, Indiana
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:

Matthew J Provenzano attended and graduated from Johns Hopkins University School Of Medicine in 2004

NPI Data:

NPI Number: 1639388911
Provider Enumeration Date: 05/22/2007
Last Update Date: 08/24/2023

Medicare PECOS Information:

PECOS PAC ID: 5799919874
Enrollment ID: I20131002000632

Medical Identifiers

Medical identifiers for Matthew J Provenzano such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639388911	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Y00000X	Otolaryngology	01072216A (Indiana)	Secondary
207Y00000X	Otolaryngology	36490 (Iowa)	Secondary
207YP0228X	Otolaryngology - Pediatric Otolaryngology	57.019215 (Ohio)	Secondary
207YP0228X	Otolaryngology - Pediatric Otolaryngology	01072216A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Franciscan St Anthony Health - Michigan City	Michigan city, IN	Hospital
Franciscan Health Crown Point	Crown point, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Franciscan Physician Network	3072790682	983

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. Matthew J Provenzano allows following entities to bill medicare on his behalf.

Entity Name	Franciscan Physician Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486

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. Matthew J Provenzano 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
Matthew J Provenzano, MD Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800	Matthew J Provenzano, MD 1225 E Coolspring Ave Ste 300, Michigan City, IN 46360-6312 Ph: (219) 878-5032

Reviews and Comments

Otolaryngology Doctors in Michigan City, IN

David Miller, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Michigan City, IN 46360 Phone: 219-878-5031 Fax: 219-878-5052
Dr. Chad Alan Glazer, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 8865 W 400 N Ste 120, Michigan City, IN 46360 Phone: 219-878-5031 Fax: 219-879-5498
William Rosevear, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Michigan City, IN 46360 Phone: 219-878-5032 Fax: 219-878-5052
David Lee Colgrove, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Suite 300, Michigan City, IN 46360 Phone: 219-878-5032 Fax: 219-861-8151

Matthew J Provenzano, MD - Medicare Otolaryngology in Michigan City, IN