Individual provider Active NPI

Jessica Castro Schoenhals, PA-C

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1407215247
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019536 Issued in NY
Practice address
1150 Youngs Rd Ste 104
Williamsville, NY 14221-8096
Phone
(716) 636-7979
Fax
(716) 929-0192
NPI assigned
Feb 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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 019536 NY Primary

Addresses

Primary practice location

1150 Youngs Rd Ste 104
Williamsville, NY 14221-8096

Mailing address

1150 Youngs Rd
Ste 104
Williamsville, NY 14221-8024
Phone (716) 636-7979

Other identifiers 1

IdentifierTypeStateIssuer
019536OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000632 NY Practitioner - Physician Assistant 0042519282 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northtowns Imaging PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jschoenhals@highgatemedical.medentdirect.com

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": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1407215247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 YOUNGS RD",
            "address_2": "STE 104",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218024",
            "telephone_number": "716-636-7979",
            "fax_number": "716-636-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 YOUNGS RD STE 104",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218096",
            "telephone_number": "716-636-7979",
            "fax_number": "716-929-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENHALS",
        "first_name": "JESSICA",
        "middle_name": "CASTRO",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "019536",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.