Individual provider Active NPI

Matthew Farnsworth, PA-C

  • Physician Assistant
  • Au Sable Forks, NY
National Provider Identifier
1053863100
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021608 Issued in NY
Practice address
15 Pleasant Street
Au Sable Forks, NY 12912
Phone
(518) 647-8164
NPI assigned
Oct 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 021608 NY Primary

Addresses

Primary practice location

15 Pleasant Street
Au Sable Forks, NY 12912

Mailing address

15 Pleasant Street
Au Sable Forks, NY 12912
Phone (518) 647-8164

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
I20171227000841 NY Practitioner - Physician Assistant 8729362207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adirondack Medical CenterGroup PAC ID 9638081284, 85 clinicians

Practice addresses (Care Compare)

203 Old Military Rd
Lake Placid, NY 12946-1738
Phone (518) 523-1717

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 897-2981

7 Stetson Rd
Tupper Lake, NY 12986-2014
Phone (518) 359-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Medical Center CurrentSince May 1, 2025 Accepting new patients
Elizabethtown Community Hospital CurrentSince Nov 6, 2017 Accepting new patients
Elizabethtown Community Hospital CurrentSince Nov 6, 2017 Accepting new patients
Adirondack Medical Center Past Accepting new patients

Locations

285 County Route 47
Saranac Lake, NY 12983
Phone (518) 897-2800

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

7 Stetson Rd
Tupper Lake, NY 12986
Phone (518) 359-7000

Interoperability endpoints

  • Direct secure messaging: mfarnsworth465473@direct.uvmhealth.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1053863100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PLEASANT STREET",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "12912",
            "telephone_number": "518-647-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PLEASANT STREET",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "12912",
            "telephone_number": "518-647-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Au Sable Forks, NY

Sources for this page

Verify at the official NPI Registry.