Michael Wittek, RPA
Individual provider Active NPI Medical Physician Assistant · Wolcott, NY
NPI 1043301161 · NPPES record last updated Apr 28, 2021
Key facts
- NPI
- 1043301161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 006198 (NY)
- Practice address
- 6254 Lawville Rd
Wolcott, NY 14590-9792 - Phone
- (315) 594-9444
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Western New York Medical Practice PC
Practice addresses (Care Compare)
100 Kings Hwy S
Rochester, NY 14617-5504
1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050705000211 | NY | Practitioner - Physician Assistant | 1557307246 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester General Hospital | Current |
Accepting new patients | |
| Rochester General Hospital | Current |
Accepting new patients | |
| Western New York Medical Practice PC | Current |
Accepting new patients | |
| Finger Lakes Community Health | Current |
Accepting new patients | |
| Finger Lakes Community Health | Current |
Accepting new patients | |
| Western New York Medical Practice P.C. | Current |
Accepting new patients |
Locations
2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472
601B W Washington St
Geneva, NY 14456
Phone (315) 781-8448
1200 Fairway 7
Macedon, NY 14502
Phone (315) 359-8230
1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122
100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553
6254 Lawville Rd
Wolcott, NY 14590
Phone (315) 594-9444
Interoperability endpoints
- mwittek33987@direct.rochesterregional.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 006198 | NY | Yes |
Addresses
Primary practice location
6254 Lawville Rd
Wolcott, NY 14590-9792
Mailing address
326 N Main St
Canandaigua, NY 14424-1222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P019006198 | Other | NY | BLUE CHOICE PROVIDER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mwittek33987@direct.rochesterregional.org |
Other providers in Wolcott, NY
- Walgreen Co
- Wayne LTC Pharmacy Inc
- Adam Jon Weis
- Kathryn Welkley
- Melissia Wheeler
- Wolcott Area Volunteer Ambulance Corp, Inc.
- Wolcott Pharmacy LLC
- Wolcott Village Pharmacy Inc
- James Michael Yadanza
All providers in Wolcott, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.