John M Provenza, MD - Medicare Gastroenterology in Shreveport, LA

John M Provenza, MD is a medicare enrolled "Internal Medicine - Gastroenterology" physician in Shreveport, Louisiana. He went to Louisiana State University School Of Medicine In Shreveport and graduated in 1984 and has 40 years of diverse experience with area of expertise as Gastroenterology. He is a member of the group practice Gastrointestinal Specialists A M C, Capitol City Family Health Center Incorporated, Gi Specialists Hospitalists At Wkmc and his current practice location is 8383 Millicent Way Ste B, Shreveport, Louisiana. You can reach out to his office (for appointments etc.) via phone at (318) 631-9121.

John M Provenza is licensed to practice in Louisiana (license number 017860) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1225028434.

Contact Information

John M Provenza, MD
8383 Millicent Way Ste B,
Shreveport, LA 71115
(318) 631-9121
(318) 213-6246



Physician's Profile

Full NameJohn M Provenza
GenderMale
SpecialityGastroenterology
Experience40 Years
Location8383 Millicent Way Ste B, Shreveport, Louisiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • John M Provenza attended and graduated from Louisiana State University School Of Medicine In Shreveport in 1984
  NPI Data:
  • NPI Number: 1225028434
  • Provider Enumeration Date: 10/27/2005
  • Last Update Date: 08/12/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7810972353
  • Enrollment ID: I20100831000906

Medical Identifiers

Medical identifiers for John M Provenza such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225028434NPI-NPPES
MD.017860OtherLASTATE LICENSE
1376442MedicaidLA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RG0100XInternal Medicine - Gastroenterology 017860 (Louisiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Willis Knighton Medical Center, IncShreveport, LAHospital
Christus Health Shreveport - BossierShreveport, LAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Gastrointestinal Specialists A M C054724508629
Capitol City Family Health Center Incorporated519363915134
Gi Specialists Hospitalists At Wkmc600206000112

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John M Provenza allows following entities to bill medicare on his behalf.
Entity NameGastrointestinal Specialists A M C
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932171725
PECOS PAC ID: 0547245086
Enrollment ID: O20040621000387

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Entity NameCapitol City Family Health Center Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265548614
PECOS PAC ID: 5193639151
Enrollment ID: O20051130000101

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Entity NameChristus Health Northern Louisiana
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801822762
PECOS PAC ID: 8628980554
Enrollment ID: O20060111000997

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Entity NameGi Specialists Hospitalists At Wkmc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255676870
PECOS PAC ID: 6002060001
Enrollment ID: O20130128000451

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› Verified 2 days ago

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John M Provenza is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
John M Provenza, MD
3217 Mabel St,
Shreveport, LA 71103-4022

Ph: (318) 631-9121
John M Provenza, MD
8383 Millicent Way Ste B,
Shreveport, LA 71115

Ph: (318) 631-9121

News Archive

New study reveals that many parents unaware of the dangers of e-cigarettes to children

As the use of e-cigarettes has risen dramatically in the United States in recent years, so have calls to poison centers about them. Yet many parents who use e-cigarettes - or "vape" - aren't aware of the dangers to children, according to a new study at Washington University School of Medicine in St. Louis.

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Read more News

› Verified 2 days ago


Internal Medicine Doctors in Shreveport, LA

Mansi Shah, D.O.
Gastroenterology
Medicare: Accepting Medicare Assignments
Practice Location: 1455 E Bert Koun Loop, #210, Shreveport, LA 71105
Phone: 318-798-4515    Fax: 318-798-4530
Pratik Agrawal,
Gastroenterology
Medicare: Medicare Enrolled
Practice Location: 1541 Kings Hwy, Shreveport, LA 71103
Phone: 318-626-0000    
Dr. Bader Alotaibi, M.D.
Gastroenterology
Medicare: Medicare Enrolled
Practice Location: 2727 Hearne Ave Ste 301, Shreveport, LA 71103
Phone: 318-631-6400    
Paul A Rushing, MD
Gastroenterology
Medicare: Accepting Medicare Assignments
Practice Location: 1455 E Bert Kouns Loop, Shreveport, LA 71105
Phone: 318-798-4488    Fax: 318-798-4420
Sanjay Jain,
Gastroenterology
Medicare: Medicare Enrolled
Practice Location: 510 E Stoner Ave, Primary Care (110), Shreveport, LA 71101
Phone: 318-221-8411    
Steven R Bailey, MD
Gastroenterology
Medicare: Accepting Medicare Assignments
Practice Location: 1541 Kings Hwy, Shreveport, LA 71103
Phone: 318-626-0000    
Venkateswara K Rao, M.D.,
Gastroenterology
Medicare: Medicare Enrolled
Practice Location: 1501 Kings Hwy, Department Of Medicine, Shreveport, LA 71103
Phone: 318-675-5000    

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