MARK PHILLIP PROVENZANO M.D.
NPI 1811094584
Orthopaedic Surgery - Sports Medicine in Houston, TX
NPI Status: Active since September 17, 2006
Contact Information
950 CAMPBELL RD
HOUSTON, TX
ZIP 77024
Phone: (713) 464-0077
Fax: (713) 464-9582
- Individual
- Male
- Orthopaedic Surgery
- Sports Medicine
- Accepts Insurance
- PECOS Enrolled
About MARK PROVENZANO
This page provides the complete NPI Profile along with additional information for Mark Provenzano, a provider established in Houston, Texas with a medical specialization in Orthopaedic Surgery, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1811094584 assigned on September 2006. The practitioner's primary taxonomy code is 207XX0005X with license number G3705 (TX). The provider is registered as an individual and his NPI record was last updated March 2026.
- NPI
- 1811094584
- Provider Name
- MARK PHILLIP PROVENZANO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 950 CAMPBELL RD HOUSTON, TX 77024
- Location Phone
- (713) 464-0077
- Location Fax
- (713) 464-9582
- Mailing Address
- 950 CAMPBELL RD HOUSTON, TX 77024
- Mailing Phone
- (713) 464-0077
- Mailing Fax
- (713) 464-9582
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-17-2006
- Last Update Date
- 03-04-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery Sports Medicine
- Taxonomy Code
- 207XX0005X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G3705
- License State
- TX
- Taxonomy Description
- An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| MDG3705 | OTHER (01) | TX | LICENSE NUMBER |
| 0025EP | OTHER (01) | TX | BCBS PROVIDER # |
Medicare Participation & PECOS Enrollment Status
Mark Provenzano is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1811094584, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
HOUSTON, TX 77024
HOUSTON, TX 77024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811094584, enumerated as an "individual" on September 17, 2006.
The provider is located at 950 CAMPBELL RD HOUSTON, TX 77024 and the phone number is (713) 464-0077.
Orthopaedic Surgery with taxonomy code 207XX0005X and a focus in Sports Medicine.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Medicare,. Please consult your insurance carrier or call the provider to verify.
