Active NPI
Prashula Ellsworth, PHYSICIAN ASSISTANT
- Physician Assistant
- Williamsville, NY
National Provider Identifier
1013922723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 007118-1
- Practice address
- 6333 Main St
Suite 2
Williamsville, NY 14221-5800 - Phone
- (716) 630-1164
- Fax
- (716) 630-2608
- NPI assigned
- Jul 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 007118-1 | NY | Primary |
Addresses
Primary practice location
6333 Main St
Suite 2
Williamsville, NY 14221-5800
Mailing address
6255 Sheridan Dr
Suite 304
Williamsville, NY 14221-4836
Phone (716) 857-8666
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000570254007 | Other | NY | HEALTH NOW |
| 161000580 | Other | NY | NOVA |
| 00026513001 | Other | NY | UNIVERA |
| 9512316 | Other | NY | IHA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266
5959 Big Tree Rd
Orchard Park, NY 14127-2291
Phone (716) 882-0035
6009 S Transit Rd
Suite 300
Lockport, NY 14094-6307
Phone (716) 656-4077
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007118-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Nation of Indians | Current | Accepting new patients | |
| Seneca Nation of Indians | Current | Accepting new patients |
Locations
36 Thomas Indian School Dr
Irving, NY 14081
Phone (716) 532-5582
987 R C Hoag Dr
Salamanca, NY 14779
Phone (716) 945-5894
Interoperability endpoints
- prashulae@gppc.medentdirect.com
Organizations & group practices 3
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.
-
- General Practice Physician
- Dunkirk, NY
- NPI 1093959322
-
- Federally Qualified Health Center (FQHC)
- Salamanca, NY
- NPI 1023033511
-
- Land Ambulance
- Irving, NY
- NPI 1982231890
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Derby, NY
- NPI 1225654494
Hospital
-
- General Acute Care Hospital
- Dunkirk, NY
- NPI 1215917224
-
dba Mount St. Mary's Hospital and Health Center
- General Acute Care Hospital
- Lewiston, NY
- NPI 1043394745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1013922723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 SHERIDAN DR",
"address_2": "SUITE 304",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214836",
"telephone_number": "716-857-8666",
"fax_number": "716-857-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6333 MAIN ST",
"address_2": "SUITE 2",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142215800",
"telephone_number": "716-630-1164",
"fax_number": "716-630-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLSWORTH",
"first_name": "PRASHULA",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-30",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "007118-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NOW",
"identifier": "000570254007",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOVA",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00026513001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA",
"identifier": "9512316",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.