Denise Patricia Provencher, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003979 Issued in MI

Practice address

25500 Meadowbrook Rd Ste 150
Novi, MI 48375-1880

Phone

(248) 784-3667

Fax

(248) 869-3982

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Neurosurgical Associates PCGroup PAC ID 9739139759, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: denise.provencher.p1@direct.mhsineuro.nextgenshare.com

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.

• University Neurosurgical Associates PC

  • Specialist
  • Southfield, MI
  • NPI 1699761379
  Medicare reassignment Care Compare group NPD (past)
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1780784439
  Medicare reassignment
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1710764410

  Physician Assistant

  NPD
• University Neurosurgical Associates, PC

  • Diagnostic Radiology Physician
  • Madison Heights, MI
  • NPI 1366996829
  NPD
• University Neurosurgical Associates, PC

  • Neurological Surgery Physician
  • Trenton, MI
  • NPI 1497379671
  NPD
• Seniors Wellness Group of Michigan, P.C.

  • Clinical Psychologist
  • Royal Oak, MI
  • NPI 1801848718
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1740299981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751880",
            "telephone_number": "248-784-3667",
            "fax_number": "248-869-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751880",
            "telephone_number": "248-784-3667",
            "fax_number": "248-869-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCHER",
        "first_name": "DENISE",
        "middle_name": "PATRICIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denise.provencher.p1@direct.mhsineuro.nextgenshare.com",
            "affiliation": "N",
            "address_1": "25500 Meadowbrook Rd Ste 150",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483751880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Progressive Sleep Solutions PLLC
• Prohealth Chiropractic Associates PC
• Promed Preferred Mi 2, PLLC
• Thomas Mark Prose, M.D.
• Tracy Shmar Prosser, CNA
• Providence Hospital
• Providence Park Anesthesia Associates, PC
• Providence Park Internal Medicine PC
• Providence Ventures, LLC
• Provident Dentistry

• Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.