Individual provider Active NPI

Nirvana Ahmic, PA

  • Surgical Physician Assistant
  • Rochester, NY
National Provider Identifier
1386071413
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
017024 Issued in NY
Practice address
1425 Portland Ave
Box 4500
Rochester, NY 14621-3001
Phone
(585) 922-4006
Fax
(585) 922-2951
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 017024 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Box 4500
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Box 4500
Rochester, NY 14621-3001
Phone (585) 922-4006

Other identifiers 1

IdentifierTypeStateIssuer
017024OtherNYLICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131205000694 NY Practitioner - Physician Assistant 1153558762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Sep 15, 2013 Accepting new patients
Rochester General Hospital CurrentSince Sep 15, 2013 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1425 Portland Ave
#4500
Rochester, NY 14621
Phone (585) 922-4006

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1386071413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "address_2": "BOX 4500",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4006",
            "fax_number": "585-922-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "address_2": "BOX 4500",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4006",
            "fax_number": "585-922-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMIC",
        "first_name": "NIRVANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "017024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.