Charles Mark Livingston, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

23004586 Issued in NY

Practice address

61 Main St
Suite 5
Geneseo, NY 14454-1255

Phone

(585) 243-7620

Fax

(585) 243-1132

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Chuck Livingston PA PLLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Geneseo, NY
  • NPI 1487749073
  NPD (past) Authorized official
• Robert Nicoletta MD Southern Tier Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Geneseo, NY
  • NPI 1639316664
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174625537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SOUTH STATE STREET",
            "address_2": "BOX 418",
            "city": "NUNDA",
            "state": "NY",
            "postal_code": "14517",
            "telephone_number": "585-468-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAIN ST",
            "address_2": "SUITE 5",
            "city": "GENESEO",
            "state": "NY",
            "postal_code": "144541255",
            "telephone_number": "585-243-7620",
            "fax_number": "585-243-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "CHARLES",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23-004586",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "23004586",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "23004586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Lehrer, PSY.D.
• Kevin J Lewis, MS,NCC
• Hannah Liu, PA-C
• Livingston County
• Livingston County
• Martha C Lockhart, OT/L
• Dawn Marie Logsdon, RN, PMHNP
• Keira Mahar
• Asad Majid, M.D.
• Kristie Mann, LPN

• Surgical Physician Assistant in Geneseo, NY
• Providers in Geneseo, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.