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

Q: 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.

Q: What is Lisa Provenzano's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lisa Provenzano was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

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: October 18, 2026.

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

On this page

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 Beaumont Hospital Royal Oak, 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

Phone(248) 751-7246

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

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Provenzano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Neuro Pain Consultants PC

Same address

Pain Medicine

359 ENTERPRISE CT SPC B
Bloomfield Hills, MI 48302

Reassigned Medicare billing, Michigan enrollment
31 clinicians in this Medicare group

NPI 1417936584 (248) 751-7246

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 2

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

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

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

Quality

61.24

Promoting Interoperability

Improvement Activities

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.

DR. JAMES E HONET M.D.

Pain Medicine (Pain Medicine)