NPIMap

Individual provider Active NPI

Anastas C Provatas, MD

  • Hematology & Oncology Physician
  • Alexandria, MN
National Provider Identifier
1497740054
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
105335 Issued in MN
Practice address
111 17TH Ave E
Alexandria, MN 56308-5273
Phone
(320) 763-2707
Fax
(320) 763-7883
NPI assigned
Sep 20, 2005
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 105335 MN Primary
Hematology & Oncology Physician 207RH0003X 9500693 NC

Addresses

Primary practice location

111 17TH Ave E
Alexandria, MN 56308-5273

Mailing address

610 30TH Ave W
Alexandria, MN 56308-3426
Phone (320) 763-5123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000627 MN Practitioner - Hematology/OncologyPractitioner - Medical Oncology 6103988563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
University of Connecticut School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.93 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
78.21

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
88.69
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9500693NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Hospital Current Accepting new patients
Alexandria Clinic PA Current Accepting new patients
Douglas County Hospital Hematology & Oncology Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Onslow Oncology Practice PC Past Accepting new patients
Bethany Medical Center Past Accepting new patients
Bethany Medical Center Past Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

610 30th Ave W
Alexandria, MN 56308
Phone (320) 763-2540

Interoperability endpoints

  • Direct secure messaging: aprovatas291603@fairview.direct-ci.com
  • Direct secure messaging: aprovatas871705@direct.centracare.com

Organizations & group practices 9

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.

Hospital & facility affiliations 11

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1497740054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-5123",
            "fax_number": "320-763-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085273",
            "telephone_number": "320-763-2707",
            "fax_number": "320-763-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVATAS",
        "first_name": "ANASTAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "105335",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "9500693",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.