Active NPI
Marcela Provenzano, PA-C
- Physician Assistant
- Raleigh, NC
National Provider Identifier
1346967734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-12733
- Practice address
- 10207 Cerny St Ste 102
Raleigh, NC 27617-4880 - Phone
- (919) 613-1807
- Fax
- (919) 544-6907
- NPI assigned
- Oct 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-12733 | NC | Primary |
Addresses
Primary practice location
10207 Cerny St Ste 102
Raleigh, NC 27617-4880
Mailing address
10207 Cerny St Ste 102
Raleigh, NC 27617-4880
Phone (919) 613-1807
Other practice location 1
40 Duke Medicine Circle Clinic Ij
Durham, NC 27710-6666
Phone (919) 613-2243
Other names 1
- Marcela Hernandez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Duke University School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10207 Cerny St
Raleigh, NC 27617-4880
Phone (919) 684-8111
40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111
Hospital & facility affiliations
- Duke University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-12733 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke Health Integrated Practice, Inc | Current | Accepting new patients | |
| Duke Health Integrated Practice, Inc. | Current | Accepting new patients | |
| International Clinic of the Carolinas PLLC | Past | Accepting new patients |
Locations
40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588
234 Crooked Creek Pkwy
Durham, NC 27713
Phone (919) 385-3000
10207 Cerny St
Ste 102
Raleigh, NC 27617
Phone (919) 613-1807
Interoperability endpoints
- mhernandezmatute411241@direct.medicine.duke.edu
Organizations & group practices 3
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.
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
- Orthopaedic Foot and Ankle Surgery Physician
- Durham, NC
- NPI 1518725936
-
- Internal Medicine Physician
- Raleigh, NC
- NPI 1912228347
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Raleigh, NC
- NPI 1205225646
-
- Rehabilitation Hospital Unit
- Durham, NC
- NPI 1538166061
-
- General Acute Care Hospital
- Durham, NC
- NPI 1992703540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1346967734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10207 CERNY ST STE 102",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276174880",
"telephone_number": "919-613-1807",
"fax_number": "919-544-6907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10207 CERNY ST STE 102",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276174880",
"telephone_number": "919-613-1807",
"fax_number": "919-544-6907"
}
],
"practiceLocations": [
{
"address_1": "40 Duke Medicine Circle Clinic Ij",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277106666",
"country_code": "US",
"telephone_number": "919-613-2243",
"fax_number": "919-681-8298",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PROVENZANO",
"first_name": "MARCELA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-12733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARCELA",
"last_name": "HERNANDEZ",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.