Individual provider Active NPI

Laura Ferreira Provenzano, MD

  • Nephrology Physician
  • Cleveland, OH
National Provider Identifier
1003075276
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35122434 Issued in OH
Practice address
9500 Euclid Ave # Q7
Cleveland, OH 44195-0001
Phone
(216) 445-4926
Fax
(216) 444-9378
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 35122434 OH Primary

Addresses

Primary practice location

9500 Euclid Ave # Q7
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave # Q7
Cleveland, OH 44195-0001
Phone (216) 445-4926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140206000999 OH Practitioner - NephrologyPractitioner - Internal Medicine 8628256872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35122434OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation Single Specialty CurrentSince Dec 25, 2013 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

33100 Cleveland Clinic Blvd
Avon, OH 44011
Phone (440) 695-4000

9500 Euclid Ave
#Q7
Cleveland, OH 44195
Phone (216) 444-2625

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

2429 Martin Luther King Jr Dr
Shaker Heights, OH 44120
Phone (216) 368-0004

Networks

  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • KY PPO
  • OH PPO
  • KY PPO C-SNP
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8

Interoperability endpoints

  • Direct secure messaging: lferreiraprovenzano248475@direct.ccf.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1003075276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # Q7",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-4926",
            "fax_number": "216-444-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # Q7",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-4926",
            "fax_number": "216-444-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERREIRA PROVENZANO",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35122434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.