Individual provider Active NPI

Patricia A Wetsell, RPA-C

  • Medical Physician Assistant
  • Middle Island, NY
National Provider Identifier
1265570899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005212 Issued in NY
Practice address
606 Middle Country Rd
Middle Island, NY 11953-2544
Phone
(631) 924-5060
Fax
(631) 924-8690
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 005212 NY Primary

Addresses

Primary practice location

606 Middle Country Rd
Middle Island, NY 11953-2544

Mailing address

606 Middle Country Rd
Middle Island, NY 11953-2544
Phone (631) 924-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005212NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roxanne G Carfora, DO, PC CurrentSince Jan 25, 2015 Accepting new patients
Main Street Medical, PC PastSince Mar 1, 2017 Accepting new patients

Locations

694 Motor Pkwy
Ste 101
Hauppauge, NY 11788
Phone (631) 265-9355

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265570899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532544",
            "telephone_number": "631-924-5060",
            "fax_number": "631-924-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532544",
            "telephone_number": "631-924-5060",
            "fax_number": "631-924-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETSELL",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "005212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.