Doctor profile · Federal record

Dr. Matthew Provenzano, M.D.

Pediatric Otolaryngology Physician (CMS: Otolaryngology) · Otolaryngology Physician · Otolaryngology Physician · Pediatric Otolaryngology Physician · Michigan City, IN

  • NPI 1639388911
  • Accepts Medicare
  • 22 yrs in practice
  • Licensed in 3 states
  • Male
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
1225 E Coolspring Ave Ste 300
Michigan City, IN 463606312
(219) 878-5032
fax (219) 861-8151
Mailing address
Po Box 781076
Detroit, MI 482781076

Credentials & registration

NPPES · NUCC
NPI registered
May 2007 — 19 yrs on file
Profile last updated
August 24, 2023
Year of graduation
2004 — 22 yrs since
Specialty taxonomy
207YP0228X — NUCC code
State licenses (3)
Indiana #01072216A · Iowa #36490 · Ohio #57.019215

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1639388911. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
692
Distinct HCPCS
10
Medicare allowed
$75,123
HCPCS Description Services Patients Avg allowed
99204 New patient office or other outpatient visit, 45-59 minutes 134 134 $157
99214 Established patient office or other outpatient visit, 30-39 minutes 110 91 $120
99213 Established patient office or other outpatient visit, 20-29 minutes 107 102 $85
31575 Diagnostic exam of voice box using a flexible endoscope 98 90 $121
99203 New patient office or other outpatient visit, 30-44 minutes 75 75 $105
69210 Removal of impacted ear wax 63 62 $45
99212 Established patient office or other outpatient visit, 10-19 minutes 44 43 $53
31231 Diagnostic exam of nasal passages using an endoscope 19 19 $177
99202 New patient office or other outpatient visit, 15-29 minutes 18 18 $68
92504 Exam of ear using a microscope 13 12 $27

In context: peer comparison

Among 1 peers in this city , average services per provider: 62. This provider delivers 11× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
192
Patients
101
Total drug cost
$5,413
Drug Type Claims Patients Total cost
Nortriptyline Hcl Generic 36 12 $299
Pantoprazole Sodium Generic 36 25 $356
Dexamethasone Sodium Phosphate Generic 29 21 $1,168
Ofloxacin Generic 25 20 $1,754
Betamethasone Valerate Generic 14 12 $248
Montelukast Sodium Generic 14 0 $147
Neomycin-Polymyxin-Hydrocort (Neomycin/Polymyxin B/Hydrocort) Brand 14 0 $914
Azelastine Hcl Generic 13 0 $456
Methylprednisolone Generic 11 11 $71

Hospital affiliations

CMS Hospital Compare

Frequently asked questions

Auto-generated from federal data
What is Dr. Matthew Provenzano's medical specialty?
Dr. Matthew Provenzano practices Pediatric Otolaryngology Physician in Michigan City, IN.
Where does Dr. Matthew Provenzano practice?
Dr. Matthew Provenzano practices at 1225 E Coolspring Ave Ste 300, Michigan City, IN 463606312. Office phone: 2198785032.
What is Dr. Matthew Provenzano's NPI?
Dr. Matthew Provenzano's National Provider Identifier (NPI) is 1639388911, issued by NPPES.
Does Dr. Matthew Provenzano accept Medicare assignment?
Yes. Dr. Matthew Provenzano accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Matthew Provenzano commonly perform?
Top Medicare-reported procedures in 2023: New patient office or other outpatient visit (HCPCS 99204); Established patient office or other outpatient visit (HCPCS 99214); Established patient office or other outpatient visit (HCPCS 99213). Source: CMS Medicare Physician & Other Practitioners file.