Active NPI
Louis Patrick Favata, PA-C
- Medical Physician Assistant
- Springfield, MA
National Provider Identifier
1518947159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1505
- Practice address
- 140 High St.
Springfield, MA 01199 - Phone
- (413) 794-2511
- Fax
- (413) 794-2272
- NPI assigned
- Jan 19, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1505 | MA | Primary |
Addresses
Primary practice location
140 High St.
Springfield, MA 01199
Mailing address
280 Chestnut St.
Springfield, MA 01199
Phone (413) 794-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1505 | Other | MA | LIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1505 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1518947159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 CHESTNUT ST.",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01199",
"telephone_number": "413-794-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HIGH ST.",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01199",
"telephone_number": "413-794-2511",
"fax_number": "413-794-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAVATA",
"first_name": "LOUIS",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "1505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC",
"identifier": "1505",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.