Elana Chloe McTavish, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

22237083 Issued in CT

Practice address

267 Grant St
Bridgeport, CT 06610-2870

Phone

(203) 384-3000

NPI assigned

Sep 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elana Chloe O'Hara Former name

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emctavish700462@direct.ynhh.org

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment Care Compare group NPD
• Northeast Medical Group, Inc

  • Cardiovascular Disease Physician
  • Fairfield, CT
  • NPI 1366745267
  NPD

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

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1505001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1962921023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 MEADOW HILLS DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870",
            "telephone_number": "203-384-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCTAVISH",
        "first_name": "ELANA",
        "middle_name": "CHLOE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-10",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "22237083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELANA",
            "last_name": "O'HARA",
            "middle_name": "CHLOE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William McPadden Jr., D.M.D.
• Craig A McPherson, M.D.
• Keith McPherson, LMSW
• Patricia McSherry, CAC
• Clifton McSwain II
• Mitchell S McTavish, PA-C
• Medi Spark LLC
• Rafael Mediavilla, M.S-ESL
• Medical Center Pharmacy and Home Care Center, Inc.
• Medical Specialists of Fairfield, LLC

• Surgical Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.