Individual provider Active NPI

Elecia Novak, PA

  • Physician Assistant
  • Troy, NY
National Provider Identifier
1881006302
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1300 Massachusetts Ave
Troy, NY 12180-1628
Phone
(518) 268-5234
NPI assigned
Jun 2, 2014
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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 NY Primary

Addresses

Primary practice location

1300 Massachusetts Ave
Troy, NY 12180-1628

Mailing address

9 Ryanwood CT
Gansevoort, NY 12831-1792

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

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
I20140805002627 NY Practitioner - Physician Assistant 3577780105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

573 N Greenbush Rd
Rensselaer, NY 12144-9451
Phone (518) 268-2345

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017628NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Dec 1, 2020 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

Interoperability endpoints

  • Direct secure messaging: enovak788392@direct.trinity-health.org

Organizations & group practices 3

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1881006302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RYANWOOD CT",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128311792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MASSACHUSETTS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801628",
            "telephone_number": "518-268-5234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "ELECIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.