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MATTHEW J PROVENZANO M.D. NPI 1639388911


NPI Information

NPI: 1639388911
Provider Name: MATTHEW J PROVENZANO, M.D.
Classification: Otolaryngology - 207YP0228X
Entity Type: Individual

Specialization: Pediatric Otolaryngology

PECOS Registration: Yes

Address:
1225 E COOLSPRING AVE STE 300
MICHIGAN CITY, IN
ZIP 46360
Phone: (219) 878-5032
Get Directions

Matthew J Provenzano, M.D. is a pediatric otolaryngology otolaryngology in Michigan City, IN with 20 years of experience. The provider is a pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. Matthew J Provenzano, M.D. NPI is 1639388911. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2004

The provider's business location address is:

1225 E COOLSPRING AVE STE 300
MICHIGAN CITY, IN
ZIP 46360-312
Phone: (219) 878-5032
Fax: (219) 861-8151

The NPI 1639388911 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of impact ear wax, one ear (HCPCS:69210)
  • Diagnostic examination of voice box using flexible endoscope (HCPCS:31575)
  • Diagnostic examination of ear and nose (HCPCS:92504)

The enumeration date for this NPI number is 5/22/2007 and was last updated on 8/24/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Y00000XOtolaryngology01072216AINDIANANo
2207Y00000XOtolaryngology36490IOWANo
3207YP0228XOtolaryngologyPediatric Otolaryngology57.019215OHIONo
4207YP0228XOtolaryngologyPediatric Otolaryngology01072216AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.