Individual provider Active NPI

Noa R Tia

  • Student in an Organized Health Care Education/Training Program
  • Ithaca, NY
National Provider Identifier
1780358135
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
127 W State St
Ithaca, NY 14850-5474
Phone
(607) 273-7494
NPI assigned
Aug 8, 2021
Last updated
Aug 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

127 W State St
Ithaca, NY 14850-5474

Mailing address

105 South St
Ithaca, NY 14850-5326
Phone (607) 793-3391

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260504005047 NY Practitioner - Clinical Social Worker 5597233080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

127 W State St
FL 1
Ithaca, NY 14850-5474

171 Sullys TRL
Pittsford, NY 14534-4557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Service of Ithaca Inc CurrentSince Aug 15, 2021 Accepting new patients
Family and Children Services of Ithaca PastSince Aug 15, 2021 Accepting new patients

Locations

127 W State St
Ithaca, NY 14850
Phone (607) 273-7494

127 W State St
Fl 1
Ithaca, NY 14850
Phone (607) 273-7494

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1780358135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTH ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505326",
            "telephone_number": "607-793-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIA",
        "first_name": "NOA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.