Marc Provenzano, is a medicare enrolled "Nurse Practitioner - Acute Care" in Groveton, Texas. His current practice location is
493 N Main St, Groveton, Texas. You can reach out to his office (for appointments etc.) via phone at
(281) 515-8349.
Marc Provenzano is licensed to practice in Texas (license number 1119122) 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 1285413922.
Provider's Profile
| Full Name | Marc Provenzano |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 493 N Main St, Groveton, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1285413922
- Provider Enumeration Date: 09/22/2023
- Last Update Date: 10/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 4183154891
- Enrollment ID: I20250211002042
Medical Identifiers
Medical identifiers for Marc Provenzano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1285413922 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | 1119122 (Texas) | 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. Marc Provenzano allows following entities to bill medicare on his behalf.
| Entity Name | Hospitalist Medicine Physicians Of Texas Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629307095
PECOS PAC ID: 3476688318
Enrollment ID: O20100317001021 |
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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. Marc 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 |
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Marc Provenzano,
Po Box 395,
Groveton, TX 75845-0395
Ph: () - | Marc Provenzano,
493 N Main St,
Groveton, TX 75845-2498
Ph: (281) 515-8349 |
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