Ava M Novotny, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

39350 Civic Center Dr
Suite # 300
Fremont, CA 94538-2331

Phone

(228) 762-4483

Fax

(228) 769-0406

NPI assigned

Aug 28, 2013

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

University of South Alabama College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mission Peak Orthopaedic Medical Group IncGroup PAC ID 9739165705, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ano606pcs@m1766.primeclinicalsystems.direct-ci.com

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.

• Mission Peak Orthopaedic Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Fremont, CA
  • NPI 1609888593
  Medicare reassignment Care Compare group
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• St Francis Medical Group PC

  • Urgent Care Clinic/Center
  • Hayward, CA
  • NPI 1144907916
  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1972937837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR",
            "address_2": "SUITE # 300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-797-3933",
            "fax_number": "510-797-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR",
            "address_2": "SUITE # 300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "228-762-4483",
            "fax_number": "228-769-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "AVA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION",
            "identifier": "1110125",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern California Anesthesia Associates
• Sadie Norton
• Roze Norzei
• Peter Shoichi Nose, MD
• Anthony Ryan Novello, DPT
• Novus Therapy Solutions, Inc.
• Gladys M Nulph, VN211003
• Renuka Nulu
• Maria Nunes
• Stephanie Nunes

• Physician Assistant in Fremont, CA
• Providers in Fremont, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.