Sandra Jean Williams, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

007711 Issued in NY

Practice address

1561 Long Pond Rd Ste 303
Rochester, NY 14626-4135

Phone

(585) 368-6500

Fax

(585) 368-6501

NPI assigned

Jun 23, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: sandra.williams.1@10568.direct.athenahealth.com

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1558397372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 GENESEE ST",
            "address_2": "3RD FL. BK BLDG.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113201",
            "telephone_number": "585-368-3031",
            "fax_number": "585-368-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD STE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264135",
            "telephone_number": "585-368-6500",
            "fax_number": "585-368-6501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "89 Genesee St",
            "address_2": "3rd fl. BK Bldg.",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146113201",
            "country_code": "US",
            "telephone_number": "585-368-3031",
            "fax_number": "585-368-3037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SANDRA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02506412",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Retha Diann Williams
• Ronald Williams
• Rosie Williams, NP
• Samantha Williams
• Samantha L Williams, LPN
• Sean A Williams, M.D.
• Shanetta S Williams
• Shawn Marie Williams, C PED
• Shundella Keara Williams
• Sofia N Williams

• 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 May 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.