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JEREMY M PROVENCHER PA-C
NPI 1861993743
Physician Assistant in Manchester, NH

Active since February 26, 2018PECOS EnrolledAccepts Medicare Assignment
1 ELLIOT WAY, MANCHESTER, NH 03103(603) 663-2830(603) 663-1849 Get Directions Write a Review

NPPES record last updated: September 27, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 27, 2019, Feb 26, 2018 (2 updates tracked since 2018).

About Jeremy M Provencher Pa-c NPPES

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

JEREMY M PROVENCHER PA-C (NPI 1861993743) is an individual physician assistant in Manchester, New Hampshire, licensed in New Hampshire (1333) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS, is affiliated with Elliot Hospital, and maintains a secondary practice location in Nashua.

NPPES Registry Identity

NPI1861993743
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEREMY M PROVENCHERCredential: PA-C
Location Address1 ELLIOT WAYManchester, NH 03103-3502
Mailing Address1 Elliot WayManchester, NH 03103-3502 · (603) 663-2830 · Fax (603) 663-1849
Phone(603) 663-2830
Fax(603) 663-1849
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateFebruary 26, 2018
Last NPPES UpdateSeptember 27, 20192 updates tracked since enumeration
✔ NPI 1861993743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NH · 1333
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1 ELLIOT WAY, Manchester, NH 03103
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Secondary Practice Location 1

Location 1565 Amherst StNashua, NH 03063-1048 · Phone (603) 578-3347

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

Jeremy M Provencher Pa-c 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 ID2163785510
PECOS Enrollment IDI20180417001960
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 5

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
88 services87 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
83 services82 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
24 services24 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
20 services20 patients
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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Elliot Hospital

Acute Care Hospitals · Manchester, NH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number300012
Location1 Elliot WayManchester, NH 03103 · Hillsborough County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03103 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
$89.14 typical visit price
range $57.75 – $174.26
Typical copayment $22.28 (range $14.43 – $43.56)
Most-billed visit code 99203
Established Patient
$71.85 typical visit price
range $18.70 – $142.15
Typical copayment $17.96 (range $4.67 – $35.53)
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.

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.

JUSTINA JANE VOLODZKO PA-C
Physician Assistant (Surgical)
1 ELLIOT WAY
MANCHESTER, NH 03103
Hillsborough County (603) 669-5300
ELLIOT PROFESSIONAL SERVICES
Internal Medicine (Critical Care Medicine)
1 ELLIOT WAY, ELLIOT INTENSIVIST PROGRAM
MANCHESTER, NH 03103
Hillsborough County (603) 663-2231
ELLIOT PROFESSIONAL SERVICES
Pediatrics (Neonatal-Perinatal Medicine)
1 ELLIOT WAY, NEONATOLOGY SERVICES
MANCHESTER, NH 03103
Hillsborough County (603) 663-2692
DR. BRYAN PARKER ROWE M.D.
Radiology (Radiation Oncology)
1 ELLIOT WAY
MANCHESTER, NH 03103
Hillsborough County (603) 663-1800
DR. PETER WILSON SHAW MD
Internal Medicine (Cardiovascular Disease)
1 ELLIOT WAY
MANCHESTER, NH 03103
Hillsborough County (603) 627-1669
LAURA SLASON DOBENS CRNA
Nurse Anesthetist, Certified Registered
1 ELLIOT WAY
MANCHESTER, NH 03103
Hillsborough County (603) 663-2315
DR. CHARLES BECK EASTWOOD M.D., C.M.
Anesthesiology
1 ELLIOT WAY, SUITE 200
MANCHESTER, NH 03103
Hillsborough County (603) 663-2315
MRS. ERIN HOPE FERNALD APRN
Nurse Practitioner (Family)
1 ELLIOT WAY, EMERGENCY DEPARTMENT
MANCHESTER, NH 03103
Hillsborough County (603) 663-2830

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 Jeremy Provencher's NPI number?

The NPI number for Jeremy Provencher is 1861993743. It was assigned to this individual provider in the NPPES registry on February 26, 2018.

Where is Jeremy Provencher located?

Jeremy Provencher practices at 1 Elliot Way, Manchester, NH 03103. The listed phone number is (603) 663-2830.

What is Jeremy Provencher's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jeremy Provencher enrolled in Medicare?

Yes. Jeremy Provencher 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 Jeremy Provencher affiliated with any hospitals?

According to CMS data, Jeremy Provencher is affiliated with Elliot Hospital.

When was this NPI record last updated?

The NPPES record for Jeremy Provencher was last updated on September 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.