Individual provider Active NPI

Frederick Mocniak, PA-C

  • Medical Physician Assistant
  • Endicott, NY
National Provider Identifier
1558239046
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
034985 Issued in NY
Practice address
204 Glenbrook CT
Endicott, NY 13760-4313
Phone
(607) 321-4065
NPI assigned
Oct 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 034985 NY Primary

Addresses

Primary practice location

204 Glenbrook CT
Endicott, NY 13760-4313

Mailing address

204 Glenbrook CT
Endicott, NY 13760-4313
Phone (607) 321-4065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260323002161 NY Practitioner - Physician Assistant 8820572381 Reassigns benefits to 1 organization
I20260326000025 PA Practitioner - Physician Assistant 8820572381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1699

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034985NYMDMedical Physician Assistant

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1558239046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GLENBROOK CT",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604313",
            "telephone_number": "607-321-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GLENBROOK CT",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604313",
            "telephone_number": "607-321-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCNIAK",
        "first_name": "FREDERICK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-27",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "034985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

Verify at the official NPI Registry.