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JOSE J PROVENCIO M.D.
NPI 1497781777
Psychiatry & Neurology - Neurology in Charlottesville, VA

Active since June 25, 2006PECOS EnrolledAccepts Medicare Assignment
79.39/100
CMS Quality Rating
1215 LEE ST, CHARLOTTESVILLE, VA 22908(434) 924-2101(434) 982-2580 Get Directions Write a Review

NPPES record last updated: October 9, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 9, 2020, Feb 16, 2018 (2 updates tracked since 2018).

About Jose J Provencio M.d. NPPES

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

JOSE J PROVENCIO M.D. (NPI 1497781777) is an individual neurology provider in Charlottesville, Virginia, licensed in Virginia (0101056026) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Virginia Medical Center, and is a graduate of Pennsylvania State University College Of Medicine (1993).

NPPES Registry Identity

NPI1497781777
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameJOSE J PROVENCIOCredential: M.D.
Location Address1215 LEE STCharlottesville, VA 22908-0001
Mailing AddressPo Box 9007Charlottesville, VA 22906-9007
Phone(434) 924-2101
Fax(434) 982-2580
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 1993
Enumeration DateJune 25, 2006
Last NPPES UpdateOctober 9, 20202 updates tracked since enumeration
NPPES CertifiedOctober 9, 2020
✔ NPI 1497781777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in VA · 0101056026
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
1215 LEE ST, Charlottesville, VA 22908
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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

Jose J Provencio 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 ID1759393929
PECOS Enrollment IDI20160119002455
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 3

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.

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.
120 services72 patients
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.
42 services30 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.
33 services28 patients

Hospital Affiliations CMS Care Compare

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

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number490009
Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22908 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

79.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.66
Promoting Interoperability100
Improvement Activities40
Cost57.65

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.

NORMA BRANHAM R.N., N.P.
Nurse Practitioner
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2047
FARNAZ M GAZONI MD
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2283
MARGARET K. SANDE M.D.
Emergency Medicine
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2231
KATHERINE T, FORKIN M.D.
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2283
AMBER N. INOFUENTES M.D.
Hospitalist
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 243-4288
JOY R MILLER PNP
Nurse Practitioner (Pediatrics)
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 243-2617
DR. DARREN GUFFEY M.D.
Dermatology
1215 LEE ST, BOX 800744
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-1931
SETH MORRISON MD
Pediatrics (Pediatric Gastroenterology)
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-3627

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 Jose Provencio's NPI number?

The NPI number for Jose Provencio is 1497781777. It was assigned to this individual provider in the NPPES registry on June 25, 2006.

Where is Jose Provencio located?

Jose Provencio practices at 1215 Lee St, Charlottesville, VA 22908. The listed phone number is (434) 924-2101.

What is Jose Provencio's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Jose Provencio enrolled in Medicare?

Yes. Jose Provencio 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.

Is Jose Provencio affiliated with any hospitals?

According to CMS data, Jose Provencio is affiliated with University Of Virginia Medical Center.

When was this NPI record last updated?

The NPPES record for Jose Provencio was last updated on October 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.