LISA PROVENZANO N.P.
NPI 1609051135
Nurse Practitioner in Bloomfield Hills, MI

Active since January 03, 2008PECOS EnrolledAccepts Medicare Assignment
76.88/100
CMS Quality Rating
359 ENTERPRISE CT SPC B, BLOOMFIELD HILLS, MI 48302(248) 751-7246(248) 418-2311 Get Directions Write a Review

NPPES record last updated: May 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 23, 2023, Feb 23, 2021, Jul 21, 2017 (3 updates tracked since 2017).

About Lisa Provenzano N.p. NPPES

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

LISA PROVENZANO N.P. (NPI 1609051135) is an individual nurse practitioner in Bloomfield Hills, Michigan, licensed in Michigan (4704150069) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS, is affiliated with Mclaren Oakland, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1609051135
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLISA PROVENZANOCredential: N.P.
Location Address359 ENTERPRISE CT SPC BBloomfield Hills, MI 48302-1055
Mailing Address359 Enterprise Ct Spc BBloomfield Hills, MI 48302-1055 · (248) 751-7246 · Fax (248) 418-2311
Fax(248) 418-2311
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateJanuary 3, 2008
Last NPPES UpdateMay 23, 20233 updates tracked since enumeration
NPPES CertifiedMay 23, 2023
NPI 1609051135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in MI · 4704150069
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

359 ENTERPRISE CT SPC B, Bloomfield Hills, MI 48302

Accepted Insurance

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

Lisa Provenzano N.p. 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 ID3375510548
PECOS Enrollment IDI20040916000187
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

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.
26 services22 patients

Hospital Affiliations CMS Care Compare

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

Mclaren Oakland

Acute Care Hospitals · Pontiac, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230207
Location50 N Perry StPontiac, MI 48342 · Oakland County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48302 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

76.88/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality61.24
Promoting Interoperability94
Improvement Activities40

Other Providers at the Same Location NPPES 5

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

Pain Medicine (Pain Medicine)
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302
Pain Medicine (Pain Medicine)
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302
Anesthesiology (Pain Medicine)
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302
Pain Medicine (Interventional Pain Medicine)
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302
Pain Medicine (Pain Medicine)
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302

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 Lisa Provenzano's NPI number?

The NPI number for Lisa Provenzano is 1609051135. It was assigned to this individual provider in the NPPES registry on January 3, 2008.

Where is Lisa Provenzano located?

Lisa Provenzano practices at 359 Enterprise Ct Spc B, Bloomfield Hills, MI 48302. The listed phone number is (248) 751-7246.

What is Lisa Provenzano's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lisa Provenzano enrolled in Medicare?

Yes. Lisa 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.

What insurance does Lisa Provenzano accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lisa Provenzano as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Provenzano affiliated with any hospitals?

According to CMS data, Lisa Provenzano is affiliated with Mclaren Oakland.

When was this NPI record last updated?

The NPPES record for Lisa Provenzano was last updated on May 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.