Individual provider Active NPI

Priyanca Waghmarae, PA

  • Physician Assistant
  • Cortlandt Manor, NY
National Provider Identifier
1699280446
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020902 Issued in NY
Practice address
1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone
(914) 737-9000
NPI assigned
Dec 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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 020902 NY Primary

Addresses

Primary practice location

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144

Mailing address

8365 Manchester Park Dr
East Amherst, NY 14051-1594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180307000130 NY Practitioner - Physician Assistant 9335400431 Reassigns benefits to 1 organization
I20191021002806 MA Practitioner - Physician Assistant 9335400431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020902NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 11, 2019 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: waghmarae.priyanca.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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 6

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": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1699280446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8365 MANCHESTER PARK DR",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674144",
            "telephone_number": "914-737-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGHMARAE",
        "first_name": "PRIYANCA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortlandt Manor, NY

Sources for this page

Verify at the official NPI Registry.