Individual provider Active NPI

Melissa Ann Spencer-Winker, PA

  • Physician Assistant
  • Depew, NY
National Provider Identifier
1003885385
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017771 Issued in NY
Practice address
6420 Transit Rd Ste a
Depew, NY 14043-1033
Phone
(716) 845-1600
Fax
(716) 242-0201
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0080761 NY
Dermatology Physician 207N00000X 017771 NY
Physician Assistant 363A00000X 0080761 NY
Physician Assistant 363A00000X 017771 NY Primary

Addresses

Primary practice location

6420 Transit Rd Ste a
Depew, NY 14043-1033

Mailing address

3041 Orchard Park Rd Ste C
Att: Credentialing
Orchard Park, NY 14127-1238
Phone (716) 674-3104

Other identifiers 1

IdentifierTypeStateIssuer
02564450MedicaidNY

Other names 1

  • Mrs. Melissa Ann Spencer Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040301000710 NY Practitioner - Physician Assistant 6608763156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

3041 Orchard Park Rd
Suite C
Orchard Park, NY 14127-1238
Phone (716) 674-3104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0080761NYMDDermatology Physician
017771NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saif Soniwala,M.D.,PC Current Accepting new patients
Wny Skin Surgery and Dermatology PC Past Accepting new patients

Locations

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

Interoperability endpoints

  • Direct secure messaging: mspencer@breastcarewny.medentdirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1003885385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 ORCHARD PARK RD STE C",
            "address_2": "ATT: CREDENTIALING",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271238",
            "telephone_number": "716-674-3104",
            "fax_number": "716-674-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 TRANSIT RD STE A",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431033",
            "telephone_number": "716-845-1600",
            "fax_number": "716-242-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER-WINKER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "0080761",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "017771",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0080761",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02564450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SPENCER",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.