Individual provider Active NPI

Brian Elkins Novick, M.D.

  • Allergy Physician
  • Forest Hills, NY
National Provider Identifier
1215039037
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
140070 Issued in NY
Practice address
11821 Queens Blvd Ste 601
Forest Hills, NY 11375-7206
Phone
(516) 426-8604
Fax
(718) 261-2285
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 140070 NY
Allergy Physician 207KA0200X 140070 NY Primary

Addresses

Primary practice location

11821 Queens Blvd Ste 601
Forest Hills, NY 11375-7206

Mailing address

11821 Queens Blvd Ste 601
Forest Hills, NY 11375-7206
Phone (516) 426-8604

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080912000249 NY Practitioner - Allergy/Immunology 1759457948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
140070NYMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Family Medical Docs PC Past Accepting new patients
For the Treatment of Allergies in New York, P.C. Allergy PastSince Mar 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: latitudefoodallergycare.briannovick@152968.advancedmd-direct.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1215039037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11821 QUEENS BLVD STE 601",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757206",
            "telephone_number": "516-426-8604",
            "fax_number": "718-261-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11821 QUEENS BLVD STE 601",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757206",
            "telephone_number": "516-426-8604",
            "fax_number": "718-261-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVICK",
        "first_name": "BRIAN",
        "middle_name": "ELKINS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NY",
            "license": "140070",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NY",
            "license": "140070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.