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DR. NOELLE PROVENZANO
NPI 1467078980
Internal Medicine in Philadelphia, PA

Active since June 20, 2020PECOS EnrolledAccepts Medicare Assignment
5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-8520 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 9, 2025, Jun 20, 2020 (2 updates tracked since 2020).

About Dr. Noelle Provenzano NPPES

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

DR. NOELLE PROVENZANO (NPI 1467078980) is an individual internal medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OT020268) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1467078980
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. NOELLE PROVENZANO
Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3018
Mailing Address5501 Old York RdPhiladelphia, PA 19141-3018
Phone(215) 456-8520
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 20, 2020
Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1467078980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in PA · OT020268✔ Licensed in CA · 20A24308
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5501 OLD YORK RD, Philadelphia, PA 19141
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Secondary Practice Location 1

Location 11530 S Olive StLos Angeles, CA 90015-3023 · Phone (213) 747-5542 · Fax (213) 746-9379

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

Dr. Noelle Provenzano 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 ID5496112773
PECOS Enrollment IDI20230801002262
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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 20

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

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

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 Noelle Provenzano's NPI number?

The NPI number for Noelle Provenzano is 1467078980. It was assigned to this individual provider in the NPPES registry on June 20, 2020.

Where is Noelle Provenzano located?

Noelle Provenzano practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-8520.

What is Noelle Provenzano's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Noelle Provenzano enrolled in Medicare?

Yes. Noelle Provenzano 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.

When was this NPI record last updated?

The NPPES record for Noelle Provenzano was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.