Individual provider Active NPI

Susan M Patronik, PA

  • Medical Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1245400126
Registry record updated Jan 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
017506-1 Issued in NY
Practice address
3670 S Benzing Rd
Orchard Park, NY 14127-1705
Phone
(716) 662-5357
Fax
(716) 662-2774
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA053342 PA
Medical Physician Assistant 363AM0700X 001003668 NC
Medical Physician Assistant 363AM0700X 017506-1 NY Primary

Addresses

Primary practice location

3670 S Benzing Rd
Orchard Park, NY 14127-1705

Mailing address

3670 S Benzing Rd
Orchard Park, NY 14127-1705
Phone (716) 662-5357

Other identifiers 2

IdentifierTypeStateIssuer
00028380301OtherNYUNIVERA
8103048MedicaidNC

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
I20150122000460 NY Practitioner - Physician Assistant 4284711862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orchard Park Family Practice, PCGroup PAC ID 7517937261, 14 clinicians

Practice addresses (Care Compare)

3670 S Benzing Rd
Suite a
Orchard Park, NY 14127-1741
Phone (716) 662-5357

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017506-1NYMDSpeech-Language Pathologist
MA053342PAMDPhysician Assistant
001003668NCMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: spatronic@opfp.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420329600000",
    "number": "1245400126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271705",
            "telephone_number": "716-662-5357",
            "fax_number": "716-662-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271705",
            "telephone_number": "716-662-5357",
            "fax_number": "716-662-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRONIK",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2015-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053342",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001003668",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017506-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00028380301",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8103048",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.