Dr Alyssa J Provagna, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Fort Leonard Wood, Missouri. She went to Wayne State University School Of Medicine and graduated in 2019 and has 7 years of diverse experience with area of expertise as Obstetrics/gynecology. Her current practice location is
4430 Missouri Ave, Fort Leonard Wood, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 596-1770.
Dr Alyssa J Provagna is licensed to practice in Virginia (license number 0101270674) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1578024527.
Physician's Profile
| Full Name | Dr Alyssa J Provagna |
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| Gender | Female |
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| Speciality | Obstetrics/gynecology |
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| Experience | 7 Years |
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| Location | 4430 Missouri Ave, Fort Leonard Wood, Missouri |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Alyssa J Provagna attended and graduated from Wayne State University School Of Medicine in 2019
NPI Data:
- NPI Number: 1578024527
- Provider Enumeration Date: 03/30/2019
- Last Update Date: 04/17/2026
Medicare PECOS Information:
- PECOS PAC ID: 8123472958
- Enrollment ID: I20251115000179
Medical Identifiers
Medical identifiers for Dr Alyssa J Provagna such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578024527 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 0101270674 (Virginia) | Primary |
| 208D00000X | General Practice | 010127064 (Virginia) | Secondary |
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. Dr Alyssa J Provagna 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 |
|---|
Dr Alyssa J Provagna, MD
4234 Illinois Ave,
Fort Leonard Wood, MO 65473-9098
Ph: (573) 596-1770 | Dr Alyssa J Provagna, MD
4430 Missouri Ave,
Fort Leonard Wood, MO 65473-9098
Ph: (573) 596-1770 |
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