Individual provider Active NPI

Michael Kenneth McElheran, PA

  • Physician Assistant
  • Watertown, NY
National Provider Identifier
1760471718
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010798-1 Issued in NY
Practice address
1571 Washington St
Suite 201
Watertown, NY 13601-9304
Phone
(315) 782-1650
Fax
(315) 788-8547
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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 010798-1 NY Primary

Addresses

Primary practice location

1571 Washington St
Suite 201
Watertown, NY 13601-9304

Mailing address

1571 Washington St
Suite 201
Watertown, NY 13601-9304
Phone (315) 782-1650

Other identifiers 1

IdentifierTypeStateIssuer
02897827MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070913000552 NY Practitioner - Physician Assistant 8820182470 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carthage Area Hospital IncGroup PAC ID 9931010485, 119 clinicians
North Country Orthopaedic Group PCGroup PAC ID 8426043381, 18 clinicians
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians

Practice addresses (Care Compare)

1001 W St
Carthage, NY 13619-9703
Phone (315) 493-1000

1571 Washington St
Suite 201
Watertown, NY 13601-9304
Phone (315) 782-1650

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010798-1NYMDPhysical Therapist
010798NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Area Hospital Inc CurrentSince Nov 28, 2023 Accepting new patients
Carthage Area Hospital, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Claxton Medical PC Physician Assistant CurrentSince Apr 1, 2021 Accepting new patients
Carthage Area Hospital Inc. Past Accepting new patients
Claxton-Hepburn Medical Center Past Accepting new patients

Locations

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

3 Lyon Pl
Ste 302
Ogdensburg, NY 13669
Phone (315) 393-7955

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

3 Lyon Pl
Ste 200
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ogdensburg, NY 13669
Phone (315) 394-7542

Interoperability endpoints

  • Direct secure messaging: mikemcelheranpa@ncog.medentdirect.com

Organizations & group practices 9

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 3

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1760471718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELHERAN",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010798-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02897827",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.