Ross Woodson Trent, PA-C
Individual provider Active NPI Physician Assistant · Canastota, NY
NPI 1285944355 · NPPES record last updated Nov 13, 2015
Key facts
- NPI
- 1285944355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 014291 (NY)
- Practice address
- 115 Center St
Canastota, NY 13032-1356 - Phone
- (315) 697-5272
- Fax
- (315) 697-5430
- NPI assigned
- Oct 7, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ia Tangoren MD PLLC
Practice addresses (Care Compare)
2949 Erie Blvd E
Suite 110
Syracuse, NY 13224-1460
Phone (315) 424-1430
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110115000030 | NY | Practitioner - Physician Assistant | 2163611518 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014291 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Medical PC | Current | Accepting new patients | |
| Oneida Health Systems, Inc | Past | Accepting new patients | |
| Fort Edward Rescue Squad Inc | Past | Accepting new patients | |
| Chemung Medical Services PC | Past | Accepting new patients |
Locations
5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 014291 | NY | Yes |
Addresses
Primary practice location
115 Center St
Canastota, NY 13032-1356
Mailing address
115 Center St
Canastota, NY 13032-1356
Phone (315) 697-5272
Other providers in Canastota, NY
- Maria Strong
- Kristin Mari Suchowiecki
- Tina Tannahill
- Sharle Ann Tassone
- Tracey Lynn Torrey
- Barbara Jean Vaccaro
- Walgreen Co
- Tya Warner
- Kelly Weaver
- Kathryn Lynn Wilmot
All providers in Canastota, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.