Individual provider Active NPI

Alyssa Nicole Donn, PA-C

  • Physician Assistant
  • Cheektowaga, NY
National Provider Identifier
1053090506
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030296 Issued in NY
Practice address
2475 Harlem Rd
Cheektowaga, NY 14225-4558
Phone
(716) 322-5428
Fax
(716) 529-0049
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 030296 NY Primary

Addresses

Primary practice location

2475 Harlem Rd
Cheektowaga, NY 14225-4558

Mailing address

2475 Harlem Rd
Cheektowaga, NY 14225-4558
Phone (716) 322-5428

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
I20240312000817 NY Practitioner - Physician Assistant 4486090578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kostas N Botsoglou MD LLCGroup PAC ID 8426400458, 3 clinicians

Practice addresses (Care Compare)

2475 Harlem Rd
Cheektowaga, NY 14225-4558
Phone (716) 322-5428

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030296NYMDPhysical Therapist

Organizations & group practices 1

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1053090506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254558",
            "telephone_number": "716-322-5428",
            "fax_number": "716-529-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254558",
            "telephone_number": "716-322-5428",
            "fax_number": "716-529-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONN",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.