NPIMap

Individual provider Active NPI

Ellen Levan, M.D.

  • Internal Medicine Physician
  • Fair Lawn, NJ
National Provider Identifier
1710960927
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07184800 Issued in NJ
Practice address
26-01 Pellack Drive
2ND Floor
Fair Lawn, NJ 07410
Phone
(201) 791-9340
Fax
(201) 791-9481
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07184800 NJ Primary

Addresses

Primary practice location

26-01 Pellack Drive
2ND Floor
Fair Lawn, NJ 07410

Mailing address

26-01 Pellack Drive
2ND Floor
Fair Lawn, NJ 07410
Phone (201) 791-9340

Other identifiers 1

IdentifierTypeStateIssuer
01696226MedicaidNY

Other names 1

  • Yelena Itskhoki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000054 NJ Practitioner - Internal Medicine 6507755055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

408 37TH St
Union City, NJ 07087-4994
Phone (201) 864-4477

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07184800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Medical Associates, PA Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Advanced Perioperative Medicine, P.a. CurrentSince Jun 1, 2020 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Manalapan Medical PC PastSince Oct 1, 2004 Accepting new patients
East Shore Medical PC Internal Medicine Past Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients
Personal Touch Medical Care, P.C. PastSince Aug 13, 1996 Accepting new patients

Locations

25-15 Fair Lawn Ave
Fair Lawn, NJ 07410
Phone (201) 791-5600

38 Summit Ave
Hackensack, NJ 07601
Phone (201) 343-6360

214 Terrace Ave
Hasbrouck Heights, NJ 07604
Phone (201) 288-6330

104 Lincoln Ave
Hawthorne, NJ 07506
Phone (973) 427-6800

8103 Bergenline Ave
North Bergen, NJ 07047
Phone (201) 758-0660

1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

525 Union Blvd
Totowa, NJ 07512
Phone (862) 229-0559

342 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 595-7779

1176 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 283-0002

307 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 722-9556

1777 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 831-1800

541 Cedar Hill Ave
Wyckoff, NJ 07481
Phone (201) 447-6262

Interoperability endpoints

  • Direct secure messaging: ellen.levan.2@5968.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1710960927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26-01 PELLACK DRIVE",
            "address_2": "2ND FLOOR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-9340",
            "fax_number": "201-791-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26-01 PELLACK DRIVE",
            "address_2": "2ND FLOOR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-9340",
            "fax_number": "201-791-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVAN",
        "first_name": "ELLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07184800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01696226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YELENA",
            "last_name": "ITSKHOKI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.