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Individual provider Active NPI

David J Novelli, M.D.

  • Family Medicine Physician
  • Elma, NY
National Provider Identifier
1093776445
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
128300-1 Issued in NY
Practice address
2731 Transit Rd Ste 107
Elma, NY 14059-9039
Phone
(716) 677-4178
Fax
(855) 816-9607
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 128300-1 NY Primary

Addresses

Primary practice location

2731 Transit Rd Ste 107
Elma, NY 14059-9039

Mailing address

2731 Transit Rd Ste 107
Elma, NY 14059-9039
Phone (716) 677-4178

Other identifiers 4

IdentifierTypeStateIssuer
00617294MedicaidNY
128300-1OtherNYLICENSE
33D0949004OtherNYCLIA
16-1172119OtherNYTAX ID

Other names 1

  • Dr. David J Novelli Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080312000684 NY Practitioner - Family Practice 4082646708 Receives reassigned benefits from 4 practitioners
Practice locations: Elma, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2731 Transit Rd
Suite 107
Elma, NY 14059-9039
Phone (716) 677-4178

Hospital & facility affiliations

  • McAuley Seton Home Care Corp Chha Home health agency, Buffalo, NY, CCN 337251
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
128300-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David John Novelli Family Medicine CurrentSince Oct 4, 1999 Accepting new patients
David S. Clifford, MD Family Medicine Past Accepting new patients
Trinity Medical Wny PC Past Accepting new patients
Trinity Medical Wny PC Past Accepting new patients

Locations

2731 Transit Rd
Ste 107
Elma, NY 14059
Phone (716) 677-4178

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 4

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.

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093776445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 TRANSIT RD STE 107",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140599039",
            "telephone_number": "716-677-4178",
            "fax_number": "855-816-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 TRANSIT RD STE 107",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140599039",
            "telephone_number": "716-677-4178",
            "fax_number": "855-816-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVELLI",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "128300-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00617294",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "128300-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "33D0949004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "16-1172119",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "NOVELLI",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elma, NY

Sources for this page

Verify at the official NPI Registry.