Michael W Ravotti, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA000863L Issued in PA

Practice address

236 Jamesway Rd
Ebensburg, PA 15931-4207

Phone

(814) 472-7336

Fax

(814) 472-7485

NPI assigned

Apr 13, 2010

Last updated

Apr 14, 2010By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1629394911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 JAMESWAY RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314207",
            "telephone_number": "814-472-7336",
            "fax_number": "814-472-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVOTTI",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000863L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Ebensburg, PA
• Providers in Ebensburg, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.