KATHRYN PROVONCHE (PA) – Physician Assistant, NPI 1790236644

KATHRYN PROVONCHE (PA) is a healthcare provider. based in Newark, Delaware. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for KATHRYN PROVONCHE (PA) is 1790236644

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN PROVONCHE (PA)
NPI
1790236644
Phone
(302) 623-0188
Address
4755 OGLETOWN STANTON RD STE 5A43
Enumeration Date
16 October 2016
Last Update Date
28 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3023682883
Graduation Year
2018 (8 years ago)
PAC ID
5496005167
Group Practice PAC ID
1052337201
Professional Enrollment ID
I20180830002693
Address ID
DE197132058NE33XXXDRXX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

757 PHYSICIAN ASSISTANT in DE

Provider Addresses for KATHRYN PROVONCHE (PA)

  • 4755 OGLETOWN STANTON RD STE 5A43

    NEWARK, DE 197182200

    Phone: (302) 623-0188

    Type: Location

  • 200 HYGEIA DR STE 2300

    NEWARK, DE 197132049

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2018-08-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180830002693IPhysician AssistantDETBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99235Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes1616$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 19718)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052337201View full group profile
NameSpecialtyState
Infectious DiseaseDE
Infectious DiseaseDE
Physician AssistantDE
Infectious DiseaseNJ
Physician AssistantDE
Infectious DiseaseDE
Physician AssistantDE
Infectious DiseaseNJ
Infectious DiseaseDE
Infectious DiseaseDE

Reviews

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Frequently asked questions

What unique ID ties claims to KATHRYN PROVONCHE (PA)?
NPI 1790236644 is assigned to KATHRYN PROVONCHE (PA) under the national enumeration system.
Is KATHRYN PROVONCHE (PA) active in the national directory?
KATHRYN PROVONCHE (PA)'s public NPI profile is in an active state.
What kind of provider is KATHRYN PROVONCHE (PA)?
The page reflects Physician Assistant for KATHRYN PROVONCHE (PA). Clinical services aligned with this taxonomy classification.
What location metadata exists for KATHRYN PROVONCHE (PA)?
The page summarizes Newark, Delaware for KATHRYN PROVONCHE (PA); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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