Jay A Provenzano, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2886 Issued in MA

Practice address

25 School St
Suite B-2
Quincy, MA 02169-6607

Phone

(617) 689-0440

Fax

(617) 689-0420

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• J & M Pro P.C.

  • Chiropractor
  • Quincy, MA
  • NPI 1457514853
  Medicare reassignment Authorized official
• Federal Injury Center of Boston Inc

  • Chiropractor
  • Boston, MA
  • NPI 1881533305
  NPD Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1114095304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SCHOOL ST",
            "address_2": "SUITE B-2",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696607",
            "telephone_number": "617-689-0440",
            "fax_number": "617-689-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SCHOOL ST",
            "address_2": "SUITE B-2",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696607",
            "telephone_number": "617-689-0440",
            "fax_number": "617-689-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "JAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Prickett
• Timothy C Prince, FNPC
• Adam L Prisby, M.ED
• Prohealth Supply LLC
• Jascha Propp, MA
• Veronica Prudente
• Andrew Joseph Pryharski, MD
• Diana S Puerta
• Kim Marie Purdy
• Puzzle Pieces, LLC

• Chiropractor in Quincy, MA
• Providers in Quincy, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.