Dr Robert Provenzano, MD - Medicare Internal Medicine in Portland, OR

Dr Robert Provenzano, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Portland, Oregon. His current practice location is 1547 Ne 40th Ave Ste B, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (855) 397-0197.

Dr Robert Provenzano is licensed to practice in Michigan (license number RP047354) 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 1972505584.

Contact Information

Dr Robert Provenzano, MD
1547 Ne 40th Ave Ste B,
Portland, OR 97232-1862
(855) 397-0197
Not Available

Map and Direction




Physician's Profile

Full NameDr Robert Provenzano
GenderMale
SpecialityInternal Medicine - Nephrology
Location1547 Ne 40th Ave Ste B, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1972505584
  • Provider Enumeration Date: 08/12/2005
  • Last Update Date: 11/26/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 2163310095
  • Enrollment ID: I20091211000158

Medical Identifiers

Medical identifiers for Dr Robert Provenzano such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972505584NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RN0300XInternal Medicine - Nephrology M-11205 (Idaho)Secondary
207RN0300XInternal Medicine - Nephrology 4301047354 (Michigan)Secondary
207RN0300XInternal Medicine - Nephrology 54729 (Arizona)Secondary
207RN0300XInternal Medicine - Nephrology 2017-00405 (North Carolina)Secondary
207RN0300XInternal Medicine - Nephrology 40429 (South Carolina)Secondary
207RN0300XInternal Medicine - Nephrology MD463387 (Pennsylvania)Secondary
207RN0300XInternal Medicine - Nephrology ME118456 (Florida)Secondary
207RN0300XInternal Medicine - Nephrology 48234 (Colorado)Secondary
207RN0300XInternal Medicine - Nephrology MD0000053388 (Tennessee)Secondary
207RN0300XInternal Medicine - Nephrology MD170613 (Oregon)Secondary
207RN0300XInternal Medicine - Nephrology RP047354 (Michigan)Primary

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. Dr Robert 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 AddressPractice Location Address
Dr Robert Provenzano, MD
1840 E Ray Rd,
Chandler, AZ 85225-8720

Ph: (855) 397-0197
Dr Robert Provenzano, MD
1547 Ne 40th Ave Ste B,
Portland, OR 97232-1862

Ph: (855) 397-0197

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.