Meagan Adell Wasacz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

018763 Issued in NY

Practice address

2435 6TH Ave
Troy, NY 12180

Phone

(518) 274-5143

NPI assigned

Jun 26, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Meagan Potratz Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sasaki Medical LLCGroup PAC ID 3779879903, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

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.

• Sasaki Medical LLC

  • Addiction Medicine (Family Medicine) Physician
  • Roseville, MN
  • NPI 1326490475
  Medicare reassignment Care Compare group NPD
• Community Care Physicians, PLLC

  • Family Medicine Physician
  • Ballston Spa, NY
  • NPI 1548541246
  NPD (past)
• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Glens Falls, NY
  • NPI 1972558179
  NPD (past)
• Sasaki Medical LLC

  • Addiction Medicine (Family Medicine) Physician
  • St Paul, MN
  • NPI 1043829625
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1427430388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 GLENRIDGE RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024523",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 6TH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-274-5143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1882 New Scotland Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Slingerlands",
            "state": "NY",
            "postal_code": "121593627",
            "country_code": "US",
            "telephone_number": "518-439-2460",
            "fax_number": "518-439-3025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Franklin St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123052100",
            "country_code": "US",
            "telephone_number": "518-372-7031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Elm St",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "128013670",
            "country_code": "US",
            "telephone_number": "518-793-7273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Old Route 6",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105122107",
            "country_code": "US",
            "telephone_number": "845-225-5202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASACZ",
        "first_name": "MEAGAN",
        "middle_name": "ADELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018763",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420800",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "POTRATZ",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamara Walker
• Stephanie Walsh, RN
• Dawn M Walters, LMSW
• Tamara Warika, LPN
• Denise Warren
• Kyle Omar Washington, FNP-BC
• Robert R Washington
• Akeisha Dorcia Watkins, LPN
• Jenna Louise Watson, CNM
• Kerri Lynn Watson, LCSW

• Physician Assistant in Troy, NY
• Providers in Troy, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.