Robert Provenzano, MD
Robert Provenzano, MD is a Nephrology Physician in Portland, OR, registered under NPI 1972505584.
Getting there
The practice address on file is 1547 NE 40TH AVE STE B, Portland, OR 97232. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| RP047354 | MI | Nephrology Physician primary |
| M-11205 | ID | Nephrology Physician |
| 4301047354 | MI | Nephrology Physician |
| 54729 | AZ | Nephrology Physician |
| 2017-00405 | NC | Nephrology Physician |
| 40429 | SC | Nephrology Physician |
| MD463387 | PA | Nephrology Physician |
| ME118456 | FL | Nephrology Physician |
| 48234 | CO | Nephrology Physician |
| MD0000053388 | TN | Nephrology Physician |
| MD170613 | OR | Nephrology Physician |
Licences are recorded in 10 states: MI, ID, AZ, NC, SC, PA, FL, CO, TN, OR. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
Licensed in 10 states
This provider holds licences in 10 states: Arizona, Colorado, Florida, Idaho, Michigan, North Carolina, Oregon, Pennsylvania, South Carolina and Tennessee. The practice address on file is in Portland, OR, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Nephrology covers
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. NUCC Health Care Provider Taxonomy, code 207RN0300X
All registered taxonomy codes
This provider registers 11 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207RN0300X | Nephrology Physician Nephrology | RP047354 | MI | primary |
| 207RN0300X | Nephrology Physician Nephrology | M-11205 | ID | |
| 207RN0300X | Nephrology Physician Nephrology | 4301047354 | MI | |
| 207RN0300X | Nephrology Physician Nephrology | 54729 | AZ | |
| 207RN0300X | Nephrology Physician Nephrology | 2017-00405 | NC | |
| 207RN0300X | Nephrology Physician Nephrology | 40429 | SC | |
| 207RN0300X | Nephrology Physician Nephrology | MD463387 | PA | |
| 207RN0300X | Nephrology Physician Nephrology | ME118456 | FL | |
| 207RN0300X | Nephrology Physician Nephrology | 48234 | CO | |
| 207RN0300X | Nephrology Physician Nephrology | MD0000053388 | TN | |
| 207RN0300X | Nephrology Physician Nephrology | MD170613 | OR |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1972505584 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Aug 12, 2005 |
| Last updated | Nov 26, 2019 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
1547 NE 40TH AVE STE B Portland, OR 97232 (855) 397-0197 |
| Mailing address |
1840 E RAY RD Chandler, AZ 85225 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 9 | 7 | 2 | 5 | 0 | 5 | 5 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 9 | 5 | 2 | 1 | 0 | 1 | 5 | 7 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.