AUGIE N. PROVENCIO – Family Medicine Physician, NPI 1467590158
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,260 FAMILY PRACTICE in AZ
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Provider Addresses for AUGIE N. PROVENCIO
600 B ST BLDG A-C
LIVINGSTON, CA 953349593
Phone: (209) 850-3500
Type: Mailing
Huntington Drive, West Arcadia, Arcadia, Los Angeles County, California, 91007, United States
SUITE 300
ARCADIA, CA 910066203
Phone: (626) 447-0296
Fax: (626) 447-6057
Type: Mailing
Whiteriver Indian Hospital, 200, West Hospital Drive, Whiteriver, Navajo County, Arizona, 85941, United States
WHITERIVER, AZ 85941
Phone: (928) 338-4911
Type: Location
200 W Hospital Dr
Whiteriver, AZ 85941
Phone: (928) 338-4911
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $96.
Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.
Last reported payment date: 2024-06-05 • Largest payer in this snapshot: Lilly USA, LLC ($96).
Total Amount
$96
General + Research + Ownership
Payments
2
Total payment records
General Amount
$96
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $96 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-12-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071203000559 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 69 | 43 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 32 | $0 |
Insurance plans in this area (ZIP 95334)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | AZ | 71010 | X-ray of chest, 1 view, front | 28 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| O T O L A R Y N G O L O G Y | CA | |
| Obstetrics/Gynecology, Family Practice | CA | |
| Gastroenterology, Internal Medicine | CA | |
| Family Practice | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA |
Reviews
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