Active NPI
Yelizaveta Bavosa, PA-C
- Physician Assistant
- Ellicott City, MD
National Provider Identifier
1053778449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0006070
- Practice address
- 3300 Centennial LN
Ellicott City, MD 21042-3600 - Phone
- (866) 389-2727
- NPI assigned
- Jan 15, 2016
- Last updated
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0006070 | MD | Primary |
Addresses
Primary practice location
3300 Centennial LN
Ellicott City, MD 21042-3600
Mailing address
3300 Centennial LN
Ellicott City, MD 21042-3600
Phone (866) 389-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Scott T Maurer MD LLC | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://api.platform.athenahealth.com/19508/brand/1/csg/1/fhir/r4
- yelizaveta.bavosa.1@19508.direct.athenahealth.com
Organizations & group practices 3
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Geriatric Medicine (Internal Medicine) Physician
- Glenwood, MD
- NPI 1699361493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1053778449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 CENTENNIAL LN",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210423600",
"telephone_number": "866-389-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CENTENNIAL LN",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210423600",
"telephone_number": "866-389-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAVOSA",
"first_name": "YELIZAVETA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-15",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0006070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.