HEATHER LYNNE PROVENCHER M.D.
NPI 1295024420
Hospitalist in San Francisco, CA

Q: What is Heather Provencher's NPI number?

The NPI number for Heather Provencher is 1295024420. It was assigned to this individual provider in the NPPES registry on March 28, 2011.

Q: What is Heather Provencher's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Active since March 28, 2011PECOS EnrolledAccepts Medicare Assignment

97.22/100

CMS Quality Rating

1101 VAN NESS AVE, SAN FRANCISCO, CA 94109(415) 600-6000 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Heather Lynne Provencher M.d. NPPES

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

HEATHER LYNNE PROVENCHER M.D. (NPI 1295024420) is an individual hospitalist provider in San Francisco, California, licensed in California (A125198) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS and is a graduate of University Of Vermont College Of Medicine (2011).

NPPES Registry Identity

NPI1295024420

Entity TypeIndividualFemale

Primary Taxonomy208M00000X

Provider Legal NameHEATHER LYNNE PROVENCHERCredential: M.D.

Location Address1101 VAN NESS AVESan Francisco, CA 94109-6919

Mailing Address1101 Van Ness AveSan Francisco, CA 94109-6919

Phone(415) 600-6000

Sole ProprietorYes

Medical School CMSUniversity Of Vermont College Of MedicineGraduated 2011

Enumeration DateMarch 28, 2011

Last NPPES UpdateAugust 28, 2024

NPPES CertifiedAugust 28, 2024

✔ NPI 1295024420 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in CA · A125198

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

1101 VAN NESS AVE, San Francisco, CA 94109

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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

Heather Lynne Provencher 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 ID2668603846

PECOS Enrollment IDI20171002000478

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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

511 services177 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

94 services92 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

89 services88 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

57 services29 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

51 services51 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

30 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94109 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.22/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

88.33

Promoting Interoperability

100

Improvement Activities

Cost

69.53

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Patient lift, electric with seat or sling E0635

DME-Other DME · category DE000N

1 supplier12 claims12 services$71.56 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

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

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