Individual provider Active NPI

John B Horak, PA-C

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1912434911
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003848 Issued in CT
Practice address
80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-8000
Phone
(860) 972-9495
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA6900 MA
Physician Assistant 363A00000X 003848 CT Primary

Addresses

Primary practice location

80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-8000

Mailing address

80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-8000
Phone (609) 729-4958

Other practice location 1

759 Chestnut St # S4628
Springfield, MA 01107-1619
Phone (413) 794-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170828002839 CT Practitioner - Physician Assistant 7113299090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003848CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Jul 1, 2020 Accepting new patients
Hartford Hospital CurrentSince Jul 1, 2020 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 10, 2017 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Interoperability endpoints

  • Direct secure messaging: john.horak@xdr.hhchealthdirect.org

Organizations & group practices 5

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1912434911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL CARDIOLOGY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "609-729-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL CARDIOLOGY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-9495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Chestnut St # S4628",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011071619",
            "country_code": "US",
            "telephone_number": "413-794-5550",
            "fax_number": "413-794-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORAK",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.