Active NPI
Edward S Piechocki, PA
- Physician Assistant
- Warsaw, NY
National Provider Identifier
1750389714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 00596-1
- Practice address
- 408 N Main St
Warsaw, NY 14569-1015 - Phone
- (585) 786-2290
- Fax
- (585) 786-2853
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00596-1 | NY | Primary |
Addresses
Primary practice location
408 N Main St
Warsaw, NY 14569-1015
Mailing address
408 N Main St
Warsaw, NY 14569-1015
Phone (585) 786-2290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01984752 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000596 | NY | MD | Behavioral Analyst |
| 00596-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Consultants Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Stockton, CA
- NPI 1972534048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750389714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 N MAIN ST",
"city": "WARSAW",
"state": "NY",
"postal_code": "145691015",
"telephone_number": "585-786-2290",
"fax_number": "585-786-2853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 N MAIN ST",
"city": "WARSAW",
"state": "NY",
"postal_code": "145691015",
"telephone_number": "585-786-2290",
"fax_number": "585-786-2853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIECHOCKI",
"first_name": "EDWARD",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "00596-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01984752",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.