Individual provider Active NPI

Mary C Schimp, PA-C

  • Physician Assistant
  • Emporium, PA
National Provider Identifier
1083991814
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055195 Issued in PA
Practice address
416 N Broad St
Emporium, PA 15834-1402
Phone
(814) 486-2202
Fax
(814) 788-4616
NPI assigned
Nov 8, 2011
Last updated
Nov 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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 MA055195 PA Primary

Addresses

Primary practice location

416 N Broad St
Emporium, PA 15834-1402

Mailing address

1404 Baltimore St
Suite 4
Hanover, PA 17331-8698
Phone (717) 637-0470

Other names 1

  • Mary C Stewart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120103000507 PA Practitioner - Physician Assistant 5395911986 Reassigns benefits to 2 organizations
I20140321001005 NY Practitioner - Physician Assistant 5395911986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Port Allegany Area Family Practice PCGroup PAC ID 4789669144, 3 clinicians
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1 Willow St
Port Allegany, PA 16743-1332
Phone (814) 642-9531

26 Bolivar Dr
Bradford, PA 16701-3125
Phone (814) 817-4690

2729 W State St
Olean, NY 14760-1826
Phone (716) 379-6507

Hospital & facility affiliations

  • Upmc Cole Hospital, Coudersport, PA, CCN 391313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017240NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Jan 26, 2025 Accepting new patients
Wellnow Urgent Care Practice, PC PastSince Jan 26, 2026 Accepting new patients
Bradford Emergency Associates PC Past Accepting new patients
Exigence Medical of Olean, PLLC Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

2729 W State St
Olean, NY 14760
Phone (716) 379-6507

26 Bolivar Dr
Bradford, PA 16701
Phone (814) 817-4690

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1083991814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 BALTIMORE ST",
            "address_2": "SUITE 4",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173318698",
            "telephone_number": "717-637-0470",
            "fax_number": "717-637-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BROAD ST",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341402",
            "telephone_number": "814-486-2202",
            "fax_number": "814-788-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIMP",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STEWART",
            "middle_name": "C",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Emporium, PA

Sources for this page

Verify at the official NPI Registry.