Individual provider Active NPI

Daniel Fiske, PA-C

  • Physician Assistant
  • Kingston, NY
National Provider Identifier
1154139988
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
918 Ulster Ave
Kingston, NY 12401-1372
Phone
(845) 454-0120
NPI assigned
Dec 26, 2024
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 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 NU Primary

Addresses

Primary practice location

918 Ulster Ave
Kingston, NY 12401-1372

Mailing address

918 Ulster Ave
Kingston, NY 12401-1372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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
I20250403001984 NY Practitioner - Physician Assistant 1153845870 Reassigns benefits to 1 organization
I20260221000484 CT Practitioner - Physician Assistant 1153845870 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

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

1955 Route 52
Hopewell Junction, NY 12533-3513
Phone (845) 897-4660

500 Mamaroneck Ave
Harrison, NY 10528-1633
Phone (203) 869-1145

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 1, 2026 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC Physician Assistant CurrentSince Apr 1, 2025 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 1, 2026 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

500 Mamaroneck Ave
Harrison, NY 10528
Phone (203) 869-1145

918 Ulster Ave
Kingston, NY 12401
Phone (845) 339-8900

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 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": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1154139988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 ULSTER AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 ULSTER AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011372",
            "telephone_number": "845-454-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISKE",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.