Active NPI
George Eugene Cameron, PAC
- Physician Assistant
- Ithaca, NY
National Provider Identifier
1417926692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005211-1
- Practice address
- 1780 Hanshaw Rd
Ithaca, NY 14850-9105 - Phone
- (607) 257-5858
- Fax
- (607) 257-1718
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005211-1 | NY | Primary |
Addresses
Primary practice location
1780 Hanshaw Rd
Ithaca, NY 14850-9105
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02559135 | Medicaid | NY | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| P00225148 | Other | NY | RR MEDICARE PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005211-1 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Em-I Medical Services PC | Past | Accepting new patients | |
| New York Em-I Medical Services PC | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- gcameron7705@direct-guthrie.org
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.
-
- Emergency Medicine Physician
- Oneonta, NY
- NPI 1316485600
Physician Assistant
-
- Emergency Medicine Physician
- Ithaca, NY
- NPI 1629182100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1417926692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 HANSHAW RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509105",
"telephone_number": "607-257-5858",
"fax_number": "607-257-1718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMERON",
"first_name": "GEORGE",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005211-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02559135",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "P00225148",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.