Individual provider Active NPI

Rebecca Pechenik Elovic, DMD

  • Prosthodontics
  • Boston, MA
National Provider Identifier
1053430348
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
17592 Issued in MA
Practice address
665 Beacon St
Suite 300
Boston, MA 02215-3202
Phone
(617) 247-8888
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 17592 MA Primary

Addresses

Primary practice location

665 Beacon St
Suite 300
Boston, MA 02215-3202

Mailing address

665 Beacon St
Suite 300
Boston, MA 02215-3202
Phone (617) 247-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181221001459 MA Order and Referring Only - DentistPractitioner - Dentist 6002151933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17592MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elovic Dental Associates, PC Prosthodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053430348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 BEACON ST",
            "address_2": "SUITE 300",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153202",
            "telephone_number": "617-247-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 BEACON ST",
            "address_2": "SUITE 300",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153202",
            "telephone_number": "617-247-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELOVIC",
        "first_name": "REBECCA",
        "middle_name": "PECHENIK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "17592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.