NPIMap

Individual provider Active NPI

Melissa Ann Spaeth, PA

  • Medical Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1649245143
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
23-010674 Issued in NY
Practice address
6300 Powers Rd
Orchard Park, NY 14127-3216
Phone
(716) 667-3200
NPI assigned
Feb 20, 2006
Last updated
Sep 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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 23-010674 NY Primary

Addresses

Primary practice location

6300 Powers Rd
Orchard Park, NY 14127-3216

Mailing address

6300 Powers Rd
Orchard Park, NY 14127-3216
Phone (716) 667-3200

Other identifiers 1

IdentifierTypeStateIssuer
02706054MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051110000923 NY Practitioner - Physician Assistant 0143248823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Physician Care PCGroup PAC ID 5799945911, 26 clinicians

Practice addresses (Care Compare)

5959 Big Tree Rd
Suite 107
Orchard Park, NY 14127-2291
Phone (716) 260-1593

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010674NYMDMental Health Counselor
23-010674NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mspaethpa@premierhealthpartners.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1649245143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 POWERS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273216",
            "telephone_number": "716-667-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 POWERS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273216",
            "telephone_number": "716-667-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAETH",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "23-010674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02706054",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.