Individual provider Active NPI

Melissa Gail Cotton, RPA C

  • Surgical Physician Assistant
  • Queensbury, NY
National Provider Identifier
1124018452
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
008509 Issued in NY
Practice address
25 Willowbrook Rd
Suite 2
Queensbury, NY 12804-5882
Phone
(518) 793-9156
Fax
(518) 793-6591
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 008509 NY Primary

Addresses

Primary practice location

25 Willowbrook Rd
Suite 2
Queensbury, NY 12804-5882

Mailing address

25 Willowbrook Rd
Suite 2
Queensbury, NY 12804-5882
Phone (518) 793-9156

Other identifiers 1

IdentifierTypeStateIssuer
02380683MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20170320000098 VT Practitioner - Physician Assistant 6608777636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008509NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Mar 1, 2017 Accepting new patients
Community Health Centers of the Rutland Region Inc CurrentSince Mar 1, 2017 Accepting new patients
Glens Falls Hospital Inc Past Accepting new patients
North Country Neurosurgical Associates PC Past Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: mcotton@chcrr.medentdirect.com

Organizations & group practices 4

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 1

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1124018452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "address_2": "SUITE 2",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "address_2": "SUITE 2",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTON",
        "first_name": "MELISSA",
        "middle_name": "GAIL",
        "credential": "RPA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "008509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02380683",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.