Individual provider Active NPI

Abby McIlwaine, PA-C

  • Physician Assistant
  • Canandaigua, NY
National Provider Identifier
1104662394
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031991 Issued in NY
Practice address
699 S Main St Ste 3
Canandaigua, NY 14424-2208
Phone
(585) 602-4500
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 031991 NY Primary

Addresses

Primary practice location

699 S Main St Ste 3
Canandaigua, NY 14424-2208

Mailing address

699 S Main St Ste 3
Canandaigua, NY 14424-2208

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
I20241115002636 NY Practitioner - Physician Assistant 9537693312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopaedic Associates of RochesterGroup PAC ID 7012909161, 149 clinicians

Practice addresses (Care Compare)

10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone (585) 275-5321

601 Elmwood Ave
Rochester, NY 14642-0001

601 Elmwood Ave Box
Rochester, NY 14642-0001
Phone (585) 275-5321

699 S Main St
Suite 3
Canandaigua, NY 14424-2208
Phone (585) 275-5321

Hospital & facility affiliations

  • F F Thompson Hospital Hospital, Canandaigua, NY, CCN 330074
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Associates of Rochester CurrentSince Sep 30, 2024 Accepting new patients
University Orthopaedic Associates of Rochester CurrentSince Sep 30, 2024 Accepting new patients

Locations

350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000

699 S Main St
Ste 3
Canandaigua, NY 14424
Phone (585) 602-1150

601 Elmwood Ave
#61913
Rochester, NY 14642
Phone (585) 275-6366

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: amcilwaine497368@direct.urmc.rochester.edu

Organizations & group practices 2

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 3

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1104662394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 S MAIN ST STE 3",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144242208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 S MAIN ST STE 3",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144242208",
            "telephone_number": "585-602-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAINE",
        "first_name": "ABBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.