Alicia J Snow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

18188 Issued in NY

Practice address

133 E Fairmount Avenue
Lakewood, NY 14750-1948

Phone

(716) 526-1183

Fax

(716) 526-1165

NPI assigned

Nov 21, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22211/brand/1/csg/1/fhir/r4

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.

• Lakeside Medical Practice PLLC

  • Clinic/Center
  • Lakewood, NY
  • NPI 1518720291
  NPD Authorized official
• County of Chautauqua - a Mun Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, NY
  • NPI 1902897374

  NY

  Medicare reassignment
• County of Chautauqua - a Mun Corp

  • Ambulance
  • Mayville, NY
  • NPI 1992244404
  NPD
• The Chautauqua Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Dunkirk, NY
  • NPI 1760747521
  NPD

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1003213992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E FAIRMOUNT AVENUE",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147501948",
            "telephone_number": "716-526-1183",
            "fax_number": "716-526-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E FAIRMOUNT AVENUE",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147501948",
            "telephone_number": "716-526-1183",
            "fax_number": "716-526-1165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E 3rd St",
            "address_2": "5th Floor Muncipal Building",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "NY",
            "postal_code": "147015433",
            "country_code": "US",
            "telephone_number": "716-661-8330",
            "fax_number": "716-661-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "ALICIA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2025-08-08",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018188-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "18188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04098757",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alicia.snow.1@22211.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Electronic Medical Record",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "107 Institute St",
            "city": "Jamestown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147016628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Scoma, RN
• Jon Scroxton, PT, DPT
• Syed Ali Raza Shamsi, M.B.B.S.
• Mark E Simons, RPH
• David C Smith, DPM
• Southern Tier Dentistry
• Southern Tier Nurse Practitioners in Psychiatry
• Step Forward Applied Behavior Analysis PLLC
• Eylessia Florintina Stilson
• Bonnelynn Marie Swanson, CCC-SLP

• All providers in Lakewood, NY
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.