Roderic T Hunt, RPA-C
Individual provider Active NPI Physician Assistant · Mayville, NY
NPI 1346219656 · NPPES record last updated Feb 29, 2012
Key facts
- NPI
- 1346219656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 003597 (NY)
- Practice address
- 95 E Chautauqua St
Mayville, NY 14757-0168 - Phone
- (716) 753-7107
- Fax
- (716) 753-7980
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003597 | NY | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exigence Medical of Jamestown PLLC | Past | Accepting new patients | |
| Exigence Medical of Hornell, PLLC | Past | Accepting new patients | |
| Emergency Physician Services of New York, P.C. | Physician Assistant | Past | Accepting new patients |
| Family Health Medical Services Jamestown Convenience Care | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 003597 | NY | Yes |
Addresses
Primary practice location
95 E Chautauqua St
Mayville, NY 14757-0168
Mailing address
95 E Chautauqua St
PO Box 168
Mayville, NY 14757-0168
Phone (716) 753-7107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9511905 | Other | NY | INDEPENDENT HEALTH |
| 000570010006 | Other | NY | BCBSWNY |
| 00026518002 | Other | NY | UNIVERA |
| 01274428 | Medicaid | NY |
Other providers in Mayville, NY
- Molly Hanft
- Wendy S Harvey
- Michelle Lee Holley
- Joey Horton
- Mary Hunt
- Alycia Y Johnson
- Amy L Johnson
- Leslie Diane Johnson
- Johnsons Village Pharmacy
- Kolnae Jones
All providers in Mayville, 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 Feb 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.