RICHARD M PROENZA (PA-C) – Surgical Physician Assistant, NPI 1982693024
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for RICHARD M PROENZA (PA-C)
1st Street, Vidalia, Toombs County, Georgia, 30474, United States
SUITE A
VIDALIA, GA 304748674
Phone: (912) 537-4411
Fax: (912) 538-8485
Mailing address matches the actual address.
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.
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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: 2004-05-19
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 |
|---|---|---|---|---|
| I20040519001394 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 59 | 55 | $0 |
| 23472 | Prosthetic repair of shoulder joint, total shoulder | 17 | 16 | $0 |
| 29823 | Removal of extensive shoulder joint tissue using an endoscope | 13 | 13 | $0 |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 12 | 12 | $0 |
| 29826 | Shaving of part of shoulder bone and repair of ligament using an endoscope | 12 | 12 | $0 |
Insurance plans in this area (ZIP 30474)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Physical Therapist In Private Practice | GA | |
| Orthopedic Surgery | GA | |
| Orthopedic Surgery | GA | |
| Orthopedic Surgery, Sports Medicine | GA | |
| Physical Therapist In Private Practice | AL | |
| Physician Assistant | GA | |
| Orthopedic Surgery | GA | |
| Physical Therapist In Private Practice | GA |
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