NPIMap

Individual provider Active NPI

Blythe E Fawcett, PA

  • Medical Physician Assistant
  • Auburn, NY
National Provider Identifier
1306986294
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
009708 Issued in NY
Practice address
37 W Garden St Ste 105
Auburn, NY 13021
Phone
(315) 252-0000
Fax
(315) 252-0070
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 009708 NY
Medical Physician Assistant 363AM0700X 009708 NY Primary

Addresses

Primary practice location

37 W Garden St Ste 105
Auburn, NY 13021

Mailing address

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 567-0455

Other identifiers 1

IdentifierTypeStateIssuer
03444915MedicaidNY

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
I20040817000215 NY Practitioner - Physician Assistant 9032182274 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

5100 W Taft Rd
Liverpool, NY 13088-4841

615 N Seward Ave
Auburn, NY 13021-2107
Phone (315) 253-9749

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009708NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Memorial Medical Services, PC CurrentSince Jul 9, 2018 Accepting new patients
Ny Urgent Care Practice, P.C. Past Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Auburn Community Hospital Past Accepting new patients
Emergency Medicine Physicians of Onondaga County, PLLC Past Accepting new patients
North Medical PC Past Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

37 W Garden St
Ste 105
Auburn, NY 13021
Phone (315) 252-0000

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Interoperability endpoints

  • Direct secure messaging: bfawcett2356669@direct.trinity-health.org

Organizations & group practices 9

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1306986294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-567-0455",
            "fax_number": "315-253-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W GARDEN ST STE 105",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-252-0000",
            "fax_number": "315-252-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "BLYTHE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009708",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03444915",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.