Shani A Wilson, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

016834 Issued in NY

Practice address

158 Orchard St
Rochester, NY 14611-1361

Phone

(585) 368-4500

Fax

(585) 436-6047

NPI assigned

Sep 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Ophelia Medical Group FL, P.a.

  • Addiction Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1588244750

  NY

  Medicare reassignment Care Compare group
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment NPD
• Trillium Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rochester, NY
  • NPI 1861496358
  Medicare reassignment
• The Unity Hospital of Rochester

  dba Unity Physician Services

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD
• Trillium Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rochester, NY
  • NPI 1265098941
  NPD
• University of Rochester

  dba Strong Memorial Hospital-University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD (past)

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1477989580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 HOLLAND ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052199",
            "telephone_number": "585-368-4500",
            "fax_number": "585-436-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 ORCHARD ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146111361",
            "telephone_number": "585-368-4500",
            "fax_number": "585-436-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANI",
        "middle_name": "A",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2020-12-02",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03743464",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Te'Ona Wilson, LCAT-P
• Robin Garrick Wilson, MD
• Saronna Asaunte ' Wilson
• Shakia Wilson
• Shalom Tahnee Wilson, LPN
• Shekeria Wilson
• Shemeka Shauntay Wilson
• Shennetta S Wilson, LPN
• Thomas Theodore Wilson, LCSW
• Tiffany M Wilson

• Medical Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.