DR. ALYSSA J PROVAGNA MD
NPI 1578024527
Obstetrics & Gynecology in Fort Leonard Wood, MO

Q: What is Alyssa Provagna's NPI number?

The NPI number for Alyssa Provagna is 1578024527. It was assigned to this individual provider in the NPPES registry on March 30, 2019.

Q: What is Alyssa Provagna's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Alyssa Provagna was last updated on April 17, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 30, 2019PECOS Enrolled

4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473(573) 596-1770 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 17, 2026, Jul 28, 2023, Mar 4, 2021 (3 updates tracked since 2021).

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About Dr. Alyssa J Provagna Md NPPES

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

DR. ALYSSA J PROVAGNA MD (NPI 1578024527) is an individual obstetrics & gynecology provider in Fort Leonard Wood, Missouri, licensed in Virginia (0101270674) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (2019).

NPPES Registry Identity

NPI1578024527

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameDR. ALYSSA J PROVAGNACredential: MD

Location Address4430 MISSOURI AVEFort Leonard Wood, MO 65473-9098

Mailing Address4234 Illinois AveFort Leonard Wood, MO 65473-9098 · (573) 596-1770

Phone(573) 596-1770

Sole ProprietorYes

Medical School CMSWayne State University School Of MedicineGraduated 2019

Enumeration DateMarch 30, 2019

Last NPPES UpdateApril 17, 20263 updates tracked since enumeration

NPPES CertifiedApril 17, 2026

✔ NPI 1578024527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in VA · 0101270674

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 010127064 (VA)

4430 MISSOURI AVE, Fort Leonard Wood, MO 65473

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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 (PECOS)

Dr. Alyssa J Provagna Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123472958

PECOS Enrollment IDI20251115000179

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 65473 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

$121.96 typical visit price

range $52.28 – $161.24

Typical copayment $30.49 (range $13.07 – $40.31)

Most-billed visit code 99204

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.