Individual provider Active NPI

Cameron Gillespie, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1558247650
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034288 Issued in NY
Practice address
35 Wyckoff St
Brooklyn, NY 11201-6304
Phone
(617) 304-1922
NPI assigned
Aug 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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 034288 NY Primary

Addresses

Primary practice location

35 Wyckoff St
Brooklyn, NY 11201-6304

Mailing address

35 Wyckoff St
Brooklyn, NY 11201-6304
Phone (617) 304-1922

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
I20251217002972 NY Order and Referring Only - Physician Assistant 9931694957

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Past Accepting new patients

Organizations & group practices 1

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": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1558247650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WYCKOFF ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016304",
            "telephone_number": "617-304-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WYCKOFF ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016304",
            "telephone_number": "617-304-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "CAMERON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.