Individual provider Active NPI

Philipp Ewert, PA

  • Physician Assistant
  • Geneva, NY
National Provider Identifier
1033486899
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
789 Pre Emption Rd
Geneva, NY 14456-2069
Phone
(315) 789-0993
NPI assigned
Nov 22, 2011
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

789 Pre Emption Rd
Geneva, NY 14456-2069

Mailing address

789 Pre Emption Rd
Geneva, NY 14456-2069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240327003081 NY Practitioner - Physician Assistant 0840637732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FLH Medical PCGroup PAC ID 6507922358, 47 clinicians

Practice addresses (Care Compare)

141 Central Ave
Keuka Park, NY 14478-9764
Phone (315) 279-5368

789 Pre Emption Rd
Suite 600
Geneva, NY 14456-2069
Phone (315) 781-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
030548NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical, PC CurrentSince Feb 3, 2024 Accepting new patients

Locations

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

28 Cayuga St
Seneca Falls, NY 13148
Phone (315) 568-4415

Interoperability endpoints

  • Direct secure messaging: p.ewert@flhmedical.medentdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1033486899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 PRE EMPTION RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 PRE EMPTION RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562069",
            "telephone_number": "315-789-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERT",
        "first_name": "PHILIPP",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.