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DR. MARK A PROVENZANO O.D.
NPI 1942486428
Optometrist in Lake Jackson, TX

Active since January 15, 2008PECOS EnrolledAccepts Medicare Assignment
123 CIRCLE WAY, LAKE JACKSON, TX 77566(979) 299-3250 Get Directions Write a Review

NPPES record last updated: April 21, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Mark A Provenzano O.d. NPPES

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

DR. MARK A PROVENZANO O.D. (NPI 1942486428) is an individual optometrist in Lake Jackson, Texas, licensed in Texas (3979TG) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS and is a graduate of University Of Houston - College Of Optometry (1988).

NPPES Registry Identity

NPI1942486428
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. MARK A PROVENZANOCredential: O.D.
Location Address123 CIRCLE WAYLake Jackson, TX 77566-5233
Mailing Address123 Circle WayLake Jackson, TX 77566-5233 · (979) 299-3250
Phone(979) 299-3250
Sole ProprietorYes
Medical School CMSUniversity Of Houston - College Of OptometryGraduated 1988
Enumeration DateJanuary 15, 2008
Last NPPES UpdateApril 21, 2009
✔ NPI 1942486428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in TX · 3979TG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
123 CIRCLE WAY, Lake Jackson, TX 77566
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Other Identifiers 7

Medicare UPINT92687
Medicare PIN00Z950TX
Medicare PIN8F9342TX
Other1073607370Railroad Medicare
Other80775QBc/bs Tx
Medicare PIN00E79K
Medicare NSC0328270001

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Providence Health Plan.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

Dr. Mark A Provenzano O.d. 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 ID8224198916
PECOS Enrollment IDI20081126000099
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 7

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
247 services241 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.
244 services126 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
119 services79 patients
Multiple measurements of eye fluid pressure over an extended time period 92100
This procedure involves recording the pressure inside your eyes at different times throughout the day. By tracking these changes, it can help detect conditions like glaucoma early, which can prevent vision loss. It's painless and non-invasive.
68 services42 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
59 services46 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
27 services27 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77566 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
$131.03 typical visit price
range $57.16 – $172.89
Typical copayment $32.75 (range $14.29 – $43.22)
Most-billed visit code 99204
Established Patient
$71.28 typical visit price
range $18.45 – $141.27
Typical copayment $17.82 (range $4.61 – $35.31)
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

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

BRAZOSPORT PROFESSIONAL EYE CLINIC INC
Optometrist
123 CIRCLE WAY
LAKE JACKSON, TX 77566
Brazoria County (979) 299-3250

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 Mark Provenzano's NPI number?

The NPI number for Mark Provenzano is 1942486428. It was assigned to this individual provider in the NPPES registry on January 15, 2008.

Where is Mark Provenzano located?

Mark Provenzano practices at 123 Circle Way, Lake Jackson, TX 77566. The listed phone number is (979) 299-3250.

What is Mark Provenzano's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mark Provenzano enrolled in Medicare?

Yes. Mark 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 Mark Provenzano accept?

Health plans from BlueCross BlueShield of Tennessee and Providence Health Plan list Mark 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.

When was this NPI record last updated?

The NPPES record for Mark Provenzano was last updated on April 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.