Ivan Ivanovich Drazek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1074875 Issued in NY

Practice address

103 Viceroy Dr
Camillus, NY 13031-3001

Phone

(315) 882-4923

NPI assigned

Nov 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Country Orthopaedic Group PCGroup PAC ID 8426043381, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carthage Area Hospital, Inc Hospital, Carthage, NY, CCN 331318
• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324
• Gouverneur Hospital Hospital, Gouverneur, NY, CCN 331315
• River Hospital Clinics Hospital, Alexandria Bay, NY, CCN 331309

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivandrazekpa@ncog.medentdirect.com

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.

• North Country Orthopaedic Group PC

  • Orthopaedic Surgery Physician
  • Watertown, NY
  • NPI 1568445344
  Medicare reassignment Care Compare group
• Claxton Medical PC

  • Pediatrics Physician
  • Ogdensburg, NY
  • NPI 1114164944
  Medicare reassignment NPD
• Claxton Medical PC

  • Family Medicine Physician
  • Ogdensburg, NY
  • NPI 1013399617

  Physician Assistant

  NPD
• Claxton-Hepburn Medical Center

  • Psychiatric Hospital Unit
  • Ogdensburg, NY
  • NPI 1346301389
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1053497388
  Care Compare affiliation
• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Ogdensburg, NY
  • NPI 1669236261
  Care Compare affiliation
• Carthage Area Hospital, Inc.

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1104234376
  Care Compare affiliation
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1629409925
  Care Compare affiliation
• River Hospital, Inc.

  • Critical Access Hospital
  • Alexandria Bay, NY
  • NPI 1003814641
  Care Compare affiliation
• River Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alexandria Bay, NY
  • NPI 1821022781
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1285814616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 VICEROY DR",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313001",
            "telephone_number": "315-882-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 VICEROY DR",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313001",
            "telephone_number": "315-882-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAZEK",
        "first_name": "IVAN",
        "middle_name": "IVANOVICH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1074875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Donald, RD
• Jack L. Donaldson
• Downing Katz Optical Company Inc
• Stephen Charles Downing, OPTICIAN
• Dr. Sarah F. Spiegelhoff, PHD, LMHC, Mental Health Counseling, PLLC
• Robert K Druger, M.D., PHD
• Kimberly Bridget Dunham, MS CCC/SLP
• Jessica Dussing
• Eckerd Corporation
• Scott A Edison, MD

• Physician Assistant in Camillus, NY
• Providers in Camillus, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.