Zachary Van Gorder, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

027726 Issued in NY

Practice address

10 Carlton Dr
Parish, NY 13131-3308

Phone

(315) 625-4388

NPI assigned

Nov 22, 2021

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zacharyvangorder@nochsi.directbygreenway.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Oswego County Health Services, Inc.

  dba ConnextCare

  • Community Health Clinic/Center
  • Pulaski, NY
  • NPI 1508850280
  Medicare reassignment NPD
• Northern Oswego County Health Services, Inc.

  • Community Health Clinic/Center
  • Central Square, NY
  • NPI 1558945402
  NPD (past)
• Northern Oswego County Health Services, Inc.

  • Community Health Clinic/Center
  • Parish, NY
  • NPI 1578963773
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1033876354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CARLTON DR",
            "city": "PARISH",
            "state": "NY",
            "postal_code": "131313308",
            "telephone_number": "315-625-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GORDER",
        "first_name": "ZACHARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "027726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Rayder, LMSW
• Rebecca Rossman, LPN
• Casey Seckner, CCC-SLP
• Kathleen Treat
• Delaney Turtura, MSW
• David Vecchio, LMSW
• Deborah Ann Vecchio, LMSW
• Kristin Lynn Visalli, LMSW
• Anna C Waite
• Linda Arline Windey, LPN

• Medical Physician Assistant in Parish, NY
• Providers in Parish, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.