KATHERINE ELIZABETH PROVAZNIK (DO) – Student in an Organized Health Care Education/Training Program, NPI 1376002311
Student in an Organized Health Care Education/Training Program
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,244 PSYCHIATRY in OH
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Provider Addresses for KATHERINE ELIZABETH PROVAZNIK (DO)
Riverside Family Practice Center, 697, Thomas Lane, Olentangy West, Columbus, Sharon, Franklin, Ohio, 43214, United States
COLUMBUS, OH 432143931
Phone: (614) 566-5414
Fax: (614) 533-0433
Type: Mailing
1260 SILAS DEANE HWY STE 101
WETHERSFIELD, CT 061094363
Phone: (860) 545-7550
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $90,000.
Total Amount is formed as General ($90,000) + Research ($0) + Ownership ($0) = $90,000.
Last reported payment date: 2023-01-26 • Largest payer in this snapshot: Biogen, Inc. ($90,000).
Total Amount
$90,000
General + Research + Ownership
Payments
1
Total payment records
General Amount
$90,000
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Biogen, Inc. | $90,000 |
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: 2025-08-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20240816002801 | I | Psychiatry | WI | TBD |
| I20250811002316 | I | Psychiatry | CT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43214)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology) | NY | |
| Physician Assistant | CT | |
| - | CT | |
| - | CT | |
| - | CT | |
| Physician Assistant | CT | |
| - | CT | |
| Emergency Medicine | CT | |
| - | CT | |
| Clinical Psychologist | CT |
Reviews
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