BRYANNE NOWAK (PA-C) – Physician Assistant, NPI 1104654417

BRYANNE NOWAK (PA-C) is a healthcare provider. based in Hartford, Connecticut. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 006832 (CT). The NPI Number for BRYANNE NOWAK (PA-C) is 1104654417

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
BRYANNE NOWAK (PA-C)
NPI
1104654417
Phone
(860) 714-4000
Address
114 WOODLAND ST
Enumeration Date
26 July 2024
Last Update Date
23 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8607146318
Graduation Year
2024 (2 years ago)
PAC ID
0042747677
Group Practice PAC ID
0941113567
Professional Enrollment ID
I20241220001837
Address ID
CT060334540GL31XXXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

3,243 PHYSICIAN ASSISTANT in CT

Provider Addresses for BRYANNE NOWAK (PA-C)

  • 114 WOODLAND ST

    HARTFORD, CT 061051208

    Phone: (860) 714-4000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241220001837IPhysician AssistantCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06105)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941113567View full group profile
NameSpecialtyState
-GA
Cardiovascular Disease (Cardiology)CT
-CT
Emergency MedicineRI
-GA
G A S T R O E N T E R O L O G YCT
Cardiovascular Disease (Cardiology)CT
Physician AssistantCT
General Surgery, Surgical OncologyCT
Internal Medicine, Cardiovascular Disease (Cardiology)CT

Reviews

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Frequently asked questions

Is BRYANNE NOWAK (PA-C) listed with a National Provider Identifier?
Yes — BRYANNE NOWAK (PA-C) has NPI 1104654417 on file in the registry.
Is BRYANNE NOWAK (PA-C) still an active registrant?
BRYANNE NOWAK (PA-C) carries an active NPI according to the public dataset.
What clinical focus is listed for BRYANNE NOWAK (PA-C)?
At a glance, BRYANNE NOWAK (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is BRYANNE NOWAK (PA-C) associated with Hartford?
Public fields place BRYANNE NOWAK (PA-C) around Hartford, Connecticut. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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