Juliette Lynn Provenzano-Gober

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

263433 Issued in NY

Practice address

155 White Plains Rd Ste 210
Tarrytown, NY 10591-5653

Phone

(914) 372-7171

NPI assigned

Apr 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Walk in Medical Urgent Care PCGroup PAC ID 0244497659, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Walk in Medical Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • New City, NY
  • NPI 1306137070
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1336466705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HALF MOON LN",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105332520",
            "telephone_number": "914-629-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD STE 210",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915653",
            "telephone_number": "914-372-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZANO-GOBER",
        "first_name": "JULIETTE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "263433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Play-Grow Physical and Occupational Therapy
• Keith Plechaty
• Sal V Pluchino, PH.D
• Patricia Mary Pompilio, RN
• Tracy Helen Posniak, LCSW
• David Clifton Pulver, M.D.
• Purchase Park Orthodontics PC (Tarrytown Orthodontics of Westchester)
• Rachel Schimmel LCSW PLLC
• Zachary David Rachmil, PT, DPT
• Sofia A Rafi, RD, CDN

• Internal Medicine Physician in Tarrytown, NY
• Providers in Tarrytown, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.