Henry Drakulich Altick, PA-C
Individual provider Active NPI Physician Assistant · New Haven, CT
NPI 1023976743 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1023976743
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 7553 (CT)
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 688-4242
- NPI assigned
- Jan 12, 2026
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
50 Division St
New Haven, CT 06511-1936
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260420000842 | CT | Practitioner - Physician Assistant | 2062988850 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7553 | CT | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | 7553 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
263 Willow St # 2
New Haven, CT 06511-2427
Other providers in New Haven, CT
- Robina Altbrandt
- Chloe Altchek
- Jordan R Alter
- Ahmed M.a. Altibi
- Frederick Lewis Altice
- Sophia Elissa Altin
- Casey J Altomaro
- Victor Altshul
- Nadeen F Alturki
- Lavanya Srisai Aluri
All providers in New Haven, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.