Individual provider Active NPI

Connor Wasilnak, PA

  • Physician Assistant
  • Johnson City, NY
National Provider Identifier
1154919280
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30 Harrison St Ste 250
Johnson City, NY 13790-2176
Phone
(607) 763-6580
Fax
(607) 763-6782
NPI assigned
Jan 5, 2021
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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 Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

30 Harrison St Ste 250
Johnson City, NY 13790-2176

Mailing address

33 Lewis Rd
FL 2
Binghamton, NY 13905-1055
Phone (607) 770-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 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
I20230103002603 NY Practitioner - Physician Assistant 6800266149 Reassigns benefits to 2 organizations
I20250611000229 PA Practitioner - Physician Assistant 6800266149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abington Memorial HospitalGroup PAC ID 3274437736, 442 clinicians

Practice addresses (Care Compare)

1200 Old York Rd
Abington, PA 19001-3720
Phone (215) 481-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
78.3
Promoting interoperability
100
Improvement activities
40
Cost
72.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029249NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Nov 6, 2022 Accepting new patients
Abington Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
Abington Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Womencare OB GYN, P.C. Past Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

30 Harrison St
Ste 250
Johnson City, NY 13790
Phone (607) 763-6580

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

1200 Old York Rd
#5
Abington, PA 19001
Phone (215) 481-4100

1200 Old York Rd
Fl Toll
Abington, PA 19001
Phone (215) 481-6784

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

Organizations & group practices 5

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1154919280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "FL 2",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051055",
            "telephone_number": "607-770-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST STE 250",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902176",
            "telephone_number": "607-763-6580",
            "fax_number": "607-763-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASILNAK",
        "first_name": "CONNOR",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.