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

Mrs. Claudia Mike Provenzale, AGNP

Individual provider Adult Health Nurse Practitioner · NPI 1245009547

Mrs. Claudia Mike Provenzale, AGNP is a Nurse Practitioner in Stony Brook, New York. Qualified in 2022, 4 years ago. Practices with New York University, a 5,884-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2023
Specialties on file
2
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

2500 Nesconset Hwy Bldg 11D
Stony Brook, NY 11790-2553
Phone: (631) 689-7899
Fax: (631) 689-7865
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 310912 (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence F310912-01 (NY)

Record details

NPI number1245009547
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP
Sole proprietorYes
NPI enumeratedDecember 28, 2023
Last updated in NPPESJanuary 16, 2026
Certification dateJanuary 16, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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