ADVANTICA DC-NOVA, LLC (NPI# 1689714875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689714875 |
| Entity Type | Organization |
| Organization Name | ADVANTICA DC-NOVA, LLC |
| Other Organization Name | ADVANTICA EYECARE |
| Practice Address |
3290 Pine Orchard Ln Suite D Ellicott City MD 21042-2374 |
| Practice Telephone | 8664252323 |
| Mailing Telephone | 8664252323 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LINDA SAUER (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 8664252323 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Other Name | Type Code |
|---|---|
| Advantica EyeCare | Other Name - Individual/Organization |
| Street Address |
3290 PINE ORCHARD LN SUITE D |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-2374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659410629 | Advantica Virginia, Lcc | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-06 |
| 1215102710 | Allied Eyecare, LLC | Point of Service | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2008-04-25 |
| 1538200027 | Advantica Southwest Virginia, LLC | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-09 |
| 1417097940 | Advantica Baltimore, Lcc | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861950792 | Danielle Coliukos | Student in an Organized Health Care Education/Training Program | 3006 Fawnwood Dr, Ellicott City, MD 21042 | 2019-03-11 |
| 1700356110 | Sung Hee Moon | Acupuncturist | 9005 Chevrolet Dr #4, Ellicott City, MD 21042 | 2018-11-28 |
| 1902375009 | Sharon N Allen | Speech-Language Pathologist | Hcpss, 10910 Clarksville Pike, Ellicott City, MD 21042 | 2018-11-19 |
| 1043700412 | Samirawit Hailemariam | Registered Nurse | 9527 Liverpool Lane, Ellicott City, MD 21042 | 2018-05-11 |
| 1144771965 | Maryland Psychotherapy Services | Community/Behavioral Health | 7054 Dorsey Hall Dr., Suite 104, Ellicott City, MD 21042 | 2016-10-17 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1942676952 | Hyoung Keun Kim | Dentist | 10033 Baltimore Pike Suite 320, Ellicott City, MD 21042 | 2015-08-13 |
| 1356743553 | Cvs Pharmacy | Pharmacist | 3300a Centennial Lane, Ellicott City, MD 21042 | 2014-09-18 |
| 1821407719 | Zulema Roberts | Counselor | 3355 St. Johns Lane, Suite F, Ellicott City, MD 21042 | 2014-08-05 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| Find all providers in zip 21042 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659410629 | Advantica Virginia, Lcc | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-06 |
| 1538200027 | Advantica Southwest Virginia, LLC | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-09 |
| 1417097940 | Advantica Baltimore, Lcc | PACE Provider Organization | 3290 Pine Orchard Ln, Suite D, Ellicott City, MD 21042-2374 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629556824 | Absolutecare Inc | PACE Provider Organization | 7515 Annapolis Rd Ste 206, Hyattsville, MD 20784-1740 | 2018-07-31 |
| 1669758066 | Helping Lovng Hands,llc | PACE Provider Organization | 14167 Castle Blvd Apt 204, Silver Spring, MD 20904-4787 | 2011-10-29 |
| 1184608598 | Calvert Hospice, Inc. | PACE Provider Organization | 238 Merrimac Court, Prince Frederick, MD 20678-0838 | 2005-11-30 |
| 1750718839 | Calvert Hospice, Inc | PACE Provider Organization | 238 Merrimac Ct, Prince Frederick, MD 20678-0838 | 2013-10-03 |
| 1336211929 | Johns Hopkins Health System | PACE Provider Organization | 4940 Eastern Ave, Mfl Bldg, First Floor, East, Baltimore, MD 21224-2735 | 2006-11-15 |
| City | ELLICOTT CITY |
| Zip Code | 21042 |
Please comment or provide details below to improve the information on ADVANTICA DC-NOVA, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.