Christina Gail Provenza, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1016403 Issued in MA

Practice address

2 Medical Center Dr Ste 308
Springfield, MA 01107-1271

Phone

(413) 794-7020

Fax

(413) 794-2670

NPI assigned

Apr 2, 2018

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

Medicare fee-for-service enrollment

Enrolled in MA, MD2 enrollments

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 2

Specialty

General Surgery

Education

West Virginia University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cprovenza1172588@direct.umm.edu
• Direct secure messaging: christina.provenza@xdr.hhchealthdirect.org

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 of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment Care Compare group NPD
• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909

  Surgery

  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD

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

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Care Compare affiliation

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1841796596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CENTER DR STE 308",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071271",
            "telephone_number": "413-794-7020",
            "fax_number": "413-794-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZA",
        "first_name": "CHRISTINA",
        "middle_name": "GAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "1016403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn A Proulx, CNP, PH.D.
• Shellane Prout, DPT
• Taryn Prout
• Kirsten Lee Prouty, MA, CCC-SLP
• Raeanne Provencher
• Providence Diagnostic Imaging, Inc.
• Cheryl Diane Provost, REGISTERED NURSE
• Marissa Provost
• Nikola Prpa
• Kelsy Ann Prucker

• Surgery Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.