Individual provider Active NPI

John Stuart Pillen, RPA-C

  • Physician Assistant
  • Saranac Lake, NY
National Provider Identifier
1245479476
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1085311 Issued in TX
Practice address
159 Glenwood Dr
Saranac Lake, NY 12983-2385
Phone
(518) 524-8237
Fax
(518) 897-3369
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 1085311 TX Primary

Addresses

Primary practice location

159 Glenwood Dr
Saranac Lake, NY 12983-2385

Mailing address

159 Glenwood Dr
Saranac Lake, NY 12983-2385
Phone (518) 891-3801

Other practice location 1

50 John Munn Rd
Saranac Lake, NY 12983-1341
Phone (518) 524-8237 ext. 1798

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
I20120213000584 NY Practitioner - Physician Assistant 0244497675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adirondack Medical CenterGroup PAC ID 9638081284, 85 clinicians

Practice addresses (Care Compare)

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 897-2981

7 Stetson Rd
Tupper Lake, NY 12986-2014
Phone (518) 359-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015117NYMDDental Hygienist
1085311TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Rehabilitation Center, Inc Current Accepting new patients
St Josephs Rehabilitation Center, Inc Current Accepting new patients
Adirondack Medical Center CurrentSince Jan 1, 2013 Accepting new patients

Locations

29 Church St
Lake Placid, NY 12946
Phone (518) 523-1122

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

159 Glenwood Dr
Saranac Lake, NY 12983
Phone (518) 557-4769

7 Stetson Rd
Tupper Lake, NY 12986
Phone (518) 359-7000

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 and National Provider Directory roles.

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1245479476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 GLENWOOD DR",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129832385",
            "telephone_number": "518-891-3801",
            "fax_number": "518-897-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 GLENWOOD DR",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129832385",
            "telephone_number": "518-524-8237",
            "fax_number": "518-897-3369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 John Munn Rd",
            "address_purpose": "LOCATION",
            "city": "Saranac Lake",
            "state": "NY",
            "postal_code": "129831341",
            "country_code": "US",
            "telephone_number": "518-524-8237 x1798",
            "fax_number": "518-897-3369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILLEN",
        "first_name": "JOHN",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1085311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac Lake, NY

Sources for this page

Verify at the official NPI Registry.