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MRS. CLAUDIA MIKE PROVENZALE AGNP
NPI 1245009547
Nurse Practitioner - Adult Health in Stony Brook, NY

Active since December 28, 2023PECOS EnrolledAccepts Medicare Assignment
2500 NESCONSET HWY BLDG 11D, STONY BROOK, NY 11790(631) 689-7899(631) 689-7865 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Claudia Mike Provenzale Agnp NPPES

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

MRS. CLAUDIA MIKE PROVENZALE AGNP (NPI 1245009547) is an individual adult health provider in Stony Brook, New York, licensed in New York (310912) and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1245009547
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. CLAUDIA MIKE PROVENZALECredential: AGNP
Location Address2500 NESCONSET HWY BLDG 11DStony Brook, NY 11790-2553
Mailing Address2500 Nesconset HwyStony Brook, NY 11790-2555 · (631) 689-7899 · Fax (631) 689-7685
Phone(631) 689-7899
Fax(631) 689-7865
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 28, 2023
Last NPPES UpdateJanuary 16, 2026
NPPES CertifiedJanuary 16, 2026
✔ NPI 1245009547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · 310912
Also ListedInternal MedicineTaxonomy 207R00000X · License F310912-01 (NY)
2500 NESCONSET HWY BLDG 11D, Stony Brook, NY 11790
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Claudia Mike Provenzale Agnp 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 ID6709224942
PECOS Enrollment IDI20240405002730
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.

Medicare Billing Reassignment

Medicare enrollment records show Claudia Provenzale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York University
1,065 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
204 services114 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
50 services37 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
19 services19 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
18 services18 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
15 services15 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11790 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Claudia Provenzale's NPI number?

The NPI number for Claudia Provenzale is 1245009547. It was assigned to this individual provider in the NPPES registry on December 28, 2023.

Where is Claudia Provenzale located?

Claudia Provenzale practices at 2500 Nesconset Hwy Bldg 11D, Stony Brook, NY 11790. The listed phone number is (631) 689-7899.

What is Claudia Provenzale's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Claudia Provenzale enrolled in Medicare?

Yes. Claudia Provenzale 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.

Which organization bills Medicare for Claudia Provenzale's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Claudia Provenzale reassigns Medicare benefits to New York University (Boynton Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Claudia Provenzale's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Claudia Provenzale was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.