Carol Nevulis, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

002877 Issued in NY

Practice address

2233 State Route 86
Saranac Lake, NY 12983-5644

Phone

(518) 891-4141

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carol Jubin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1184715260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-891-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-891-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVULIS",
        "first_name": "CAROL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA001333L",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "002877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "JUBIN",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mountain Medical Pediatrics
• Mountain Medical Services
• John Douglass Murray, DDS
• Taylor Lin Nedurian, PA
• Roger William Neill, DMD
• Lara Niles, FNP
• North Country Family Physicians
• North Country Healthy Heart Network, Inc
• North Country Home Services, Inc.
• Jessica Lynn Novak, CRNA

• Surgical Physician Assistant in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.