Kayla Emily Provenzano, FNP in Riverhead, NY - Medicare Nurse Practitioner

Kayla Emily Provenzano, FNP is a medicare enrolled "Nurse Practitioner - Family" in Riverhead, New York. Her current practice location is 1272 E Main St, Riverhead, New York. You can reach out to her office (for appointments etc.) via phone at (631) 284-3797.

Kayla Emily Provenzano is licensed to practice in New York (license number 350411) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609599307.

Contact Information

	Kayla Emily Provenzano, FNP
	1272 E Main St, Riverhead, NY 11901-2583
	(631) 284-3797
	Not Available

Map and Direction

Provider's Profile

Full Name	Kayla Emily Provenzano
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1272 E Main St, Riverhead, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609599307
Provider Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022

Medicare PECOS Information:

PECOS PAC ID: 6507238474
Enrollment ID: I20230202002886

Medical Identifiers

Medical identifiers for Kayla Emily Provenzano such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609599307	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	350411 (New York)	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. Kayla Emily Provenzano allows following entities to bill medicare on her behalf.

Entity Name	North Shore - Lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

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. Kayla Emily 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
Kayla Emily Provenzano, FNP 137 Dawn Dr, Centereach, NY 11720-2243 Ph: () -	Kayla Emily Provenzano, FNP 1272 E Main St, Riverhead, NY 11901-2583 Ph: (631) 284-3797

Reviews and Comments

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Kristin Sweezy, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1267 E Main St Ste A, Riverhead, NY 11901 Phone: 631-259-3290 Fax: 631-651-4925
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Jaclyn Mae Chotowicky, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1300 Roanoke Ave, Riverhead, NY 11901 Phone: 516-661-1721
Mrs. Nicole Marie Marky, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 31 Main Rd, Riverhead, NY 11901 Phone: 631-722-4400

Kayla Emily Provenzano, FNP - Medicare Nurse Practitioner in Riverhead, NY