Individual provider Active NPI

James Tkacik, PA-C

  • Medical Physician Assistant
  • Olean, NY
National Provider Identifier
1114947363
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0048831 Issued in NY
Practice address
535 Main St
Olean, NY 14760-1500
Phone
(716) 372-0141
NPI assigned
Jul 20, 2006
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4883 NY
Medical Physician Assistant 363AM0700X 0048831 NY Primary

Addresses

Primary practice location

535 Main St
Olean, NY 14760-1500

Mailing address

535 Main St
Olean, NY 14760-1500
Phone (716) 372-0141

Other identifiers 1

IdentifierTypeStateIssuer
02503799MedicaidNY

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
I20040115000594 NY Practitioner - Physician Assistant 1254232069 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004883NYMDSpecialist
0048831NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St James Hospital CurrentSince Apr 5, 2016 Accepting new patients
Olean General Hospital CurrentSince Aug 10, 2013 Accepting new patients
Olean General Hospital Physician Assistant Current Accepting new patients
Wellnow Urgent Care, PC CurrentSince Aug 20, 2019 Accepting new patients
Sleep Insights Medical Services, LLC PastSince Dec 1, 2015 Accepting new patients
Olean Open MRI PC Past Accepting new patients

Locations

411 Canisteo St
Hornell, NY 14843
Phone (607) 324-8000

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

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

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

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

515 Main St
Olean, NY 14760
Phone (716) 373-2600

515 Main St
#13282
Olean, NY 14760
Phone (716) 375-6993

4039 Route 219
Ste 101
Salamanca, NY 14779
Phone (716) 945-0361

116 Interstate Pkwy
Bradford, PA 16701
Phone (814) 362-8674

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22039/brand/2/csg/1/fhir/r4

Organizations & group practices 11

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1114947363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500",
            "telephone_number": "716-372-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500",
            "telephone_number": "716-372-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACIK",
        "first_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "4883",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0048831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02503799",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.