NPIMap

Individual provider Active NPI

William Bronner VI, PA-C

  • Physician Assistant
  • Potsdam, NY
National Provider Identifier
1306554290
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029231 Issued in NY
Practice address
50 Leroy St
Potsdam, NY 13676-1786
Phone
(315) 265-3300
NPI assigned
Nov 9, 2022
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 029231 NY Primary

Addresses

Primary practice location

50 Leroy St
Potsdam, NY 13676-1786

Mailing address

125A Black Lake Rd
Hammond, NY 13646-4153
Phone (518) 651-6257

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wbronner356072@direct.rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229000922 NY Practitioner - Physician Assistant 8224408612 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029231NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Apr 7, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 7, 2022 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 7, 2022 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Gouverneur Hospital CurrentSince Nov 7, 2022 Accepting new patients
Massena Hospital Inc CurrentSince Nov 7, 2022 Accepting new patients
Gouverneur Hospital Past Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Interoperability endpoints

  • Direct secure messaging: wbronner356072@direct.rochesterregional.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1306554290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125A BLACK LAKE RD",
            "city": "HAMMOND",
            "state": "NY",
            "postal_code": "136464153",
            "telephone_number": "518-651-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONNER",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "VI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wbronner356072@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "50 LeRoy St",
            "city": "Potsdam",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136761786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.