Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alicia P Provenzano, PA

Individual provider Physician Assistant · NPI 1396098661

Alicia P Provenzano, PA is a Physician Assistant in Raleigh, North Carolina. Graduated from Nova Southeastern Univ College of Dental Medicine in 2012, 14 years ago. Practices with Duke Health Integrated Practice Inc, a 3,094-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
14
Trained at
Nova Southeastern Univ College of Dental Medicine
Licensed in
NC
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3400 Wake Forest Rd
Raleigh, NC 27609-7317
Phone: (919) 862-2731
Fax: (919) 862-2731
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-06796 (NC)

Record details

NPI number1396098661
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 23, 2012
Last updated in NPPESNovember 15, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolNOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
Graduated 2012 (14 years in practice)
Group practice Duke Health Integrated Practice Inc — 3094 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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