Individual provider Active NPI

Michael Repicky, PA-C

  • Physician Assistant
  • Latham, NY
National Provider Identifier
1083286025
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027521 Issued in NY
Practice address
6 Wellness Way Ste 111
Latham, NY 12110-2156
Phone
(518) 213-0227
Fax
(518) 782-3816
NPI assigned
Jul 10, 2021
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 027521 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste 111
Latham, NY 12110-2156

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.repicky.mil@mail.mil

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
I20221115001727 NY Practitioner - Physician Assistant 6305214867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
98.76
Improvement activities
40
Cost
76.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027521NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PC CurrentSince Feb 4, 2024 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

6 Wellness Way
Ste 111
Latham, NY 12110
Phone (518) 213-0227

711 Troy Schenectady Rd
Ste 102
Latham, NY 12110
Phone (518) 213-0227

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

Interoperability endpoints

  • Direct secure messaging: michael.repicky.mil@mail.mil
  • Direct secure messaging: michaelrepicky@ccp.allscriptsdirect.net

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": "1625875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1083286025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 111",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-213-0227",
            "fax_number": "518-782-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPICKY",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-10",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.repicky.mil@mail.mil",
            "affiliation": "N",
            "address_1": "1 Buffington St",
            "city": "Watervliet",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121894050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.