JOHN M PROVENZA M.D.
NPI 1225028434
Internal Medicine - Gastroenterology in Shreveport, LA

Active since October 27, 2005PECOS EnrolledAccepts Medicare Assignment
8383 MILLICENT WAY STE B, SHREVEPORT, LA 71115(318) 631-9121(318) 213-6246 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 12, 2022, Jun 22, 2018 (2 updates tracked since 2018).

About John M Provenza M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN M PROVENZA M.D. (NPI 1225028434) is an individual gastroenterology provider in Shreveport, Louisiana, licensed in Louisiana (017860) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Christus Shreveport-bossier Health System, and is a graduate of Louisiana State University School Of Medicine In Shreveport (1984).

NPPES Registry Identity

NPI1225028434
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameJOHN M PROVENZACredential: M.D.
Location Address8383 MILLICENT WAY STE BShreveport, LA 71115
Mailing Address3217 Mabel StShreveport, LA 71103-4022 · (318) 631-9121 · Fax (318) 631-9126
Fax(318) 213-6246
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 1984
Enumeration DateOctober 27, 2005
Last NPPES UpdateAugust 12, 20222 updates tracked since enumeration
NPPES CertifiedAugust 12, 2022
NPI 1225028434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in LA · 017860
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
8383 MILLICENT WAY STE B, Shreveport, LA 71115

Other Identifiers 2

OtherMD.017860LA · State License
Medicaid1376442LA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John M Provenza M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810972353
PECOS Enrollment IDI20100831000906
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
231 services225 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
115 services114 patients
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
111 services50 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
110 services110 patients
Dilation of esophagus 43450
Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.
79 services79 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
64 services63 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus Shreveport-Bossier Health System

Acute Care Hospitals · Shreveport, LA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190041
Location1453 E Bert Kouns Industrial LoopShreveport, LA 71105 · Caddo County
Emergency services Birthing friendly

Willis Knighton Medical Center

Acute Care Hospitals · Shreveport, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190111
Location2600 Greenwood RoadShreveport, LA 71103 · Caddo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
Established Patient
$95.09 typical visit price
range $16.64 – $133.62
Typical copayment $23.77 (range $4.16 – $33.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
8383 MILLICENT WAY STE B
SHREVEPORT, LA 71115
Internal Medicine (Gastroenterology)
8383 MILLICENT WAY STE B
SHREVEPORT, LA 71115
Nurse Practitioner (Family)
8383 MILLICENT WAY STE B
SHREVEPORT, LA 71115
Physician Assistant (Medical)
8383 MILLICENT WAY STE B
SHREVEPORT, LA 71115
Physician Assistant
8383 MILLICENT WAY STE B
SHREVEPORT, LA 71115

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Provenza's NPI number?

The NPI number for John Provenza is 1225028434. It was assigned to this individual provider in the NPPES registry on October 27, 2005.

Where is John Provenza located?

John Provenza practices at 8383 Millicent Way Ste B, Shreveport, LA 71115. The listed phone number is (318) 631-9121.

What is John Provenza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is John Provenza enrolled in Medicare?

Yes. John Provenza is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Provenza accept?

Health plans from Blue Cross and Blue Shield of Louisiana, CHRISTUS Health Plan and HMO Louisiana list John Provenza as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is John Provenza affiliated with any hospitals?

According to CMS data, John Provenza is affiliated with Christus Shreveport-Bossier Health System and Willis Knighton Medical Center.

When was this NPI record last updated?

The NPPES record for John Provenza was last updated on August 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.