Active NPI
Ronald Anthony Novelli, PA
- Physician Assistant
- Redding, CA
National Provider Identifier
1245631159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA13754
- Practice address
- 3689 Eureka Way
Redding, CA 96001-0177 - Phone
- (530) 244-4577
- NPI assigned
- Sep 10, 2014
- Last updated
- Sep 10, 2014
- Sex
- Male
- 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 | PA13754 | CA | Primary |
Addresses
Primary practice location
3689 Eureka Way
Redding, CA 96001-0177
Mailing address
3689 Eureka Way
Redding, CA 96001-0177
Phone (530) 244-4577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13754 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1245631159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3689 EUREKA WAY",
"city": "REDDING",
"state": "CA",
"postal_code": "960010177",
"telephone_number": "530-244-4577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3689 EUREKA WAY",
"city": "REDDING",
"state": "CA",
"postal_code": "960010177",
"telephone_number": "530-244-4577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVELLI",
"first_name": "RONALD",
"middle_name": "ANTHONY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-10",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA13754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.