Claire Provenzano, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16456 Issued in TX

Practice address

7777 Forest LN Ste C106
Dallas, TX 75230-6831

Phone

(972) 566-5255

Fax

(972) 566-5236

NPI assigned

Dec 20, 2022

Last updated

Mar 1, 2023By the provider in NPPES

Sex

Female

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Joint Institute, PLLCGroup PAC ID 8325206584, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651
• Medical Center of McKinney Hospital, McKinney, TX, CCN 450403
• Mercy Hospital Marietta Hospital, Marietta, OK, CCN 371306
• Texas Health Presbyterian Hospital Allen Hospital, Allen, TX, CCN 450840

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Texas Joint Institute, PLLC

  • Orthopaedic Surgery Physician
  • Dallas, TX
  • NPI 1700160744
  Medicare reassignment Care Compare group

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

• Columbia Medical Center of McKinney Subsidiary LP

  dba Medical City McKinney

  • General Acute Care Hospital
  • McKinney, TX
  • NPI 1437102639
  Care Compare affiliation
• Columbia Medical Center of Plano Subsidiary LP

  dba Medical City Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation
• Texas Health Presbyterian Hospital Allen

  • General Acute Care Hospital
  • Allen, TX
  • NPI 1548291883
  Care Compare affiliation
• Love County Health Center

  dba Mercy Health Love County

  • Critical Access Hospital
  • Marietta, OK
  • NPI 1649221557
  Care Compare affiliation

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1477265593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306831",
            "telephone_number": "972-566-5255",
            "fax_number": "972-566-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306831",
            "telephone_number": "972-566-5255",
            "fax_number": "972-566-5236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Frisco Square Blvd",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750343305",
            "country_code": "US",
            "telephone_number": "214-618-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4001 W 15th St Ste 180",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750935836",
            "country_code": "US",
            "telephone_number": "972-566-5255",
            "fax_number": "972-566-5236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5575 Frisco Square Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750343310",
            "country_code": "US",
            "telephone_number": "972-566-5255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "CLAIRE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proteam Hospice LLC
• Kathryn Reagan Prothro, LCSW
• Xaviana Prothro
• Protouch Nurses, Inc (Protouch Staffing)
• Tyra Prout, NP-C
• Providence Anesthesia Services PLLC
• Providence Drugs LLC
• Providence Group Home
• Providence Health Care Agency LLC
• Providence Home Care LLC

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.