Jessica Dwyer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

015669 Issued in NY

Practice address

1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074

Phone

(518) 348-3176

NPI assigned

Jul 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Larosa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 3, 2025 through Nov 3, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jdwyer@landmarkhealth-direct.org

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.

• Emergency Medicine Physicians of Samaritan, PLLC

  • Emergency Medicine Physician
  • Troy, NY
  • NPI 1609815653
  NPD (past)
• Integrative Medical Associates of New York, PLLC

  • Family Medicine Physician
  • Delmar, NY
  • NPI 1518261163
  NPD (past)

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1104181387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 CENTER AVE",
            "address_2": "STE 630",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926479152",
            "telephone_number": "518-471-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TROY SCHENECTADY RD STE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101074",
            "telephone_number": "518-348-3176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4535 Dressler Rd NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182545",
            "country_code": "US",
            "telephone_number": "330-493-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWYER",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LAROSA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Susan Dudla, PHARMD
• Thomas Duff
• Tania M Durante, RPH.
• Corrina Duvall, PSY.D.
• Amanda Jayne Dvorscak, D.O.
• Sarah Kristen Dykstra, LMSW
• Frederick Eames
• Eazylift Albany, LLC
• Tara A Edick, MS CCC-SLP
• Edwin F Williams III MD Facial Plastic Surgery, PLLC

• Physician Assistant in Latham, NY
• Providers in Latham, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.