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

Dr. Michael Louis Provenzano, DC, DPT

Individual provider Physical Therapist · NPI 1225157423

Dr. Michael Louis Provenzano, DC, DPT is a Physical Therapist in Private Practice in Andover, Massachusetts. Graduated from New York Chiropractic College in 1996, 30 years ago. Accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
30
Trained at
New York Chiropractic College
Licensed in
MA
In the registry since
2007
Specialties on file
2
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

16 Haverhill St
Andover, MA 01810-3002
Phone: (978) 470-1499
Fax: (978) 470-1408
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 18057 (MA)
Chiropractor Taxonomy 111N00000X · Licence 2154 (MA)

Record details

NPI number1225157423
Entity typeIndividual (Type 1)
GenderMale
Credentials DC , DPT
Sole proprietorNo
NPI enumeratedMarch 28, 2007
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolNEW YORK CHIROPRACTIC COLLEGE
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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