Stephen G Provonsha, MD in Riverside, CA - Medicare General Practice

Stephen G Provonsha, MD is a medicare enrolled "General Practice" physician in Riverside, California. His current practice location is 10800 Magnolia Ave, Riverside, California. You can reach out to his office (for appointments etc.) via phone at (909) 353-2000.

Stephen G Provonsha is licensed to practice in California (license number G51217) 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 1598836413.

Contact Information

	Stephen G Provonsha, MD
	10800 Magnolia Ave, Riverside, CA 92505-3043
	(909) 353-2000
	Not Available

Map and Direction

Physician's Profile

Full Name	Stephen G Provonsha
Gender	Male
Speciality	General Practice
Location	10800 Magnolia Ave, Riverside, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598836413
Provider Enumeration Date: 11/13/2006
Last Update Date: 11/30/2021

Medicare PECOS Information:

PECOS PAC ID: 2264586353
Enrollment ID: I20090825000399

Medical Identifiers

Medical identifiers for Stephen G Provonsha such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598836413	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208D00000X	General Practice	G51217 (California)	Primary

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. Stephen G Provonsha allows following entities to bill medicare on his behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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. Stephen G Provonsha 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
Stephen G Provonsha, MD 10800 Magnolia Ave, Riverside, CA 92505-3043 Ph: (909) 353-2000	Stephen G Provonsha, MD 10800 Magnolia Ave, Riverside, CA 92505-3043 Ph: (909) 353-2000

Reviews and Comments

General Practice Doctors in Riverside, CA

Joann Schneider, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 6848 Magnolia Ave, Ste 130, Riverside, CA 92506 Phone: 951-683-1174 Fax: 951-682-1253
David Lee, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 7164 Magnolia Ave, Riverside, CA 92504 Phone: 951-787-8030
William John Montgomery, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 4300 Central Ave, Riverside, CA 92506 Phone: 951-222-2206 Fax: 951-222-2106
Dr. Prabha Dhalla, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 4343 Market St, Suite A, Riverside, CA 92501 Phone: 951-787-4880 Fax: 951-787-8628
Eric Kent Frykman, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 7117 Brockton Ave, Riverside, CA 92506 Phone: 951-782-3715 Fax: 951-784-3275
Dr. David Farfan, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 7877 Trey Ave, Riverside, CA 92503 Phone: 951-790-9226
Dee W. Lim, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000

Stephen G Provonsha, MD - Medicare General Practice in Riverside, CA