Brett Allen Provence, DO is a medicare enrolled "Hospitalist" physician in Baldwin Park, California. He graduated from medical school in 2008 and has 18 years of diverse experience with area of expertise as Hospitalist. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is
1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, California. You can reach out to his office (for appointments etc.) via phone at
(626) 851-1011.
Brett Allen Provence is licensed to practice in California (license number 20A11220) 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 1003048026.
Physician's Profile
| Full Name | Brett Allen Provence |
|---|
| Gender | Male |
|---|
| Speciality | Hospitalist |
|---|
| Experience | 18 Years |
|---|
| Location | 1011 Baldwin Park Blvd, Baldwin Park, California |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Brett Allen Provence graduated from medical school in 2008
NPI Data:
- NPI Number: 1003048026
- Provider Enumeration Date: 08/10/2009
- Last Update Date: 12/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 0143498543
- Enrollment ID: I20110728000521
Medical Identifiers
Medical identifiers for Brett Allen Provence such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1003048026 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208M00000X | Hospitalist | 20A11220 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Southern California Permanente Medical Group | 6002729175 | 9038 |
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. Brett Allen Provence allows following entities to bill medicare on his behalf.
| Entity Name | Southern California Permanente Medical Group |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
|---|
| Entity Name | Southern California Permanente Medical Group |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
|---|
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. Brett Allen Provence 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 Address | Practice Location Address |
Brett Allen Provence, DO 1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, CA 91706-5806 Ph: (626) 851-1011 | Brett Allen Provence, DO 1011 Baldwin Park Blvd, 4 East Hospitalist Office, Baldwin Park, CA 91706-5806 Ph: (626) 851-1011 |
Reviews and Comments