Individual provider Active NPI

Taylor Mitchell, PA-C

  • Physician Assistant
  • Hamburg, NY
National Provider Identifier
1548909351
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4909 Southwestern Blvd
Hamburg, NY 14075-2616
Phone
(716) 926-6358
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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 NY Primary

Addresses

Primary practice location

4909 Southwestern Blvd
Hamburg, NY 14075-2616

Mailing address

10033 Gowanda State Rd
North Collins, NY 14111-9773
Phone (716) 861-6431

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
I20220913002980 NY Practitioner - Physician Assistant 9638554546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028621NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC PastSince Jun 5, 2022 Accepting new patients

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1548909351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10033 GOWANDA STATE RD",
            "city": "NORTH COLLINS",
            "state": "NY",
            "postal_code": "141119773",
            "telephone_number": "716-861-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 SOUTHWESTERN BLVD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752616",
            "telephone_number": "716-926-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.