Nathan J Paddock, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

009357 Issued in NY

Practice address

1555 Long Pond Rd
Emergency Center
Rochester, NY 14626-4122

Phone

(585) 723-7005

Fax

(585) 368-4945

NPI assigned

May 19, 2006

Sex

Male

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 2

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

State licenses

Practice roles

Locations

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.

• Nicholas H. Noyes Memorial Hospital

  • General Acute Care Hospital
  • Dansville, NY
  • NPI 1982625661
  Medicare reassignment NPD
• Internal Medicine at Lakeside

  • Internal Medicine Physician
  • Brockport, NY
  • NPI 1083939722
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679526503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "EMERGENCY CENTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7005",
            "fax_number": "585-368-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "EMERGENCY CENTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7005",
            "fax_number": "585-368-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "NATHAN",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02564327",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "177741AZ",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Packard, LCSW, RN
• Jason D Pacos, MD
• Tamera Ann Paczos, M.D.
• Dawn Marie Padden-Mohr, ACNP
• Maria Paddock, NP
• Anita Jo Padgett, L.P.N
• Stephanie Taylor Padgham, LMSW
• Cristina Marie Padilla, M.D.
• Evelyn Padilla, LMSW
• Joyce D' Liz Padilla

• 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 Jul 8, 2007; 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.