Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ika Noviawaty, MD

Individual provider Clinical Neurophysiology Physician · NPI 1265675292

Ika Noviawaty, MD is an Epileptologists in Boston, Massachusetts. Qualified in 2005, 21 years ago. Practices with Boston University Neurology Associates Inc, a 61-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
21
Licensed in
MA
In the registry since
2009
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

725 Albany St Ste 7B Shapiro Bldg
Boston, MA 02118
Phone: (617) 638-8456
Fax: (617) 638-8465
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Epilepsy Physician (primary) Taxonomy 2084E0001X · Licence 265068 (MA)
Clinical Neurophysiology Physician Taxonomy 2084N0600X · Licence 265068 (MA)
Neurology Physician Taxonomy 2084N0400X · Licence 265068 (MA)

Record details

NPI number1265675292
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 6, 2009
Last updated in NPPESJuly 8, 2024
Certification dateSeptember 15, 2023

Medicare enrollment

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

Medicare specialtyEPILEPTOLOGISTS
Also practisesNEUROLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Boston University Neurology Associates Inc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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