Individual provider Active NPI

William Tweeddale, P.A.

  • Physician Assistant
  • Kingston, NY
National Provider Identifier
1043331077
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005922-1 Issued in NY
Practice address
40 Hurley Ave
Suite 4
Kingston, NY 12401-3739
Phone
(845) 338-5600
Fax
(845) 338-3058
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005922-1 NY Primary

Addresses

Primary practice location

40 Hurley Ave
Suite 4
Kingston, NY 12401-3739

Mailing address

40 Hurley Ave Ste 4
Kingston, NY 12401-3738
Phone (845) 338-5600

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
I20110602000491 NY Practitioner - Physician Assistant 5193902054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical PC Dba Emergency OneGroup PAC ID 0648161653, 22 clinicians

Practice addresses (Care Compare)

40 Hurley Ave
Suite 4
Kingston, NY 12401-3738
Phone (845) 338-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005922NYMDAcupuncturist
005922-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physician Services of Maryland, P.C. Physician Assistant Past Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1043331077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE STE 4",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013738",
            "telephone_number": "845-338-5600",
            "fax_number": "845-338-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 4",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-338-5600",
            "fax_number": "845-338-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWEEDDALE",
        "first_name": "WILLIAM",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005922-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.