Individual provider Active NPI

Cassie Renee Massicotte, PA-C

  • Physician Assistant
  • Utica, NY
National Provider Identifier
1609507227
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
035114 Issued in NY
Practice address
1903 Sunset Ave
Utica, NY 13502-5649
Phone
(315) 624-8150
Fax
(315) 797-1537
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 035114 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1903 Sunset Ave
Utica, NY 13502-5649

Mailing address

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6100

Other practice location 1

504 Fort Evans Rd Ste 204
Leesburg, VA 20176-4097
Phone (135) 445-4100

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
I20260304002013 NY Practitioner - Physician Assistant 0840772349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1903 Sunset Ave
Utica, NY 13502-5649
Phone (315) 624-8150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035114NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Feb 23, 2026 Accepting new patients
MVHS Inc CurrentSince Feb 23, 2026 Accepting new patients
Vita Family Medicine and Medspa LLC PastSince Sep 1, 2016 Accepting new patients

Locations

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

1903 Sunset Ave
Utica, NY 13502
Phone (315) 624-8150

Organizations & group practices 3

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 1

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1609507227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022517",
            "telephone_number": "315-624-6100",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025649",
            "telephone_number": "315-624-8150",
            "fax_number": "315-797-1537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 Fort Evans Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201764097",
            "country_code": "US",
            "telephone_number": "135-445-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSICOTTE",
        "first_name": "CASSIE",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035114",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.