Sean J Cavanaugh, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011833 Issued in NY

Practice address

155 Crystal Run Rd
Middletown, NY 10941-4028

Phone

(845) 703-6999

Fax

(845) 703-6297

NPI assigned

Nov 15, 2007

Last updated

Mar 27, 2013By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Arms Acres Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Carmel, NY
  • NPI 1235184227
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1730360009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "SEAN",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02909213",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catskill Anesthesia Services
• Catskill Medical PC (Middletown Physical Therapy & Pain Management)
• Catskill Orange Orthopaedics,PC (Catskill Orange Physical Therapy)
• Catskill Radiation Oncology Consultants, PLLC
• Christie Catterson
• Cayetano C. Co, MD PC
• Marguerite Cazzetta
• Gabriela Ceballos
• Florence Intia Celzo-Vista, MD
• Center for Physical Medicine&Rehabilitation (dr. neal r. dunkelman)

• Medical Physician Assistant in Middletown, NY
• Providers in Middletown, 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 Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.