Individual provider Active NPI

Carly Linick, PA-C

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1780148668
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023146 Issued in NY
Practice address
209 W State St
Ithaca, NY 14850-5489
Phone
(607) 277-4341
NPI assigned
Jan 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023146 NY Primary

Addresses

Primary practice location

209 W State St
Ithaca, NY 14850-5489

Mailing address

360 Yellow Barn Rd
Freeville, NY 13068-9626
Phone (607) 351-9073

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
I20190222000424 NY Practitioner - Physician Assistant 2769721505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

1113 Nys Rte
Suite 13
Cortland, NY 13045-3542
Phone (607) 428-8004

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

Hospital & facility affiliations

  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307
  • Guthrie Cortland Regional Medical Center Hospital, Cortland, NY, CCN 330175

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023146NYMDPhysical Rehabilitation Occupational Therapist

Interoperability endpoints

  • Direct secure messaging: clinick27543@direct.xtensys.com

Organizations & group practices 1

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 2

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": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1780148668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 YELLOW BARN RD",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689626",
            "telephone_number": "607-351-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505489",
            "telephone_number": "607-277-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINICK",
        "first_name": "CARLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.