Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alyssa G Bovalino, PA-C

Individual provider Physician Assistant · NPI 1417406398

Alyssa G Bovalino, PA-C is a Physician Assistant in Ithaca, New York. Qualified in 2016, 10 years ago. Practices with Pic Indiana PC, a 148-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
10
Licensed in
NY
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

101 Dates Dr
Ithaca, NY 14850-1342
Phone: (315) 480-8733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 020196 (NY)

Record details

NPI number1417406398
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 3, 2016
Last updated in NPPESNovember 4, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Pic Indiana Pc — 148 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

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