Individual provider Active NPI

Michelle Stoltenburg, PA

  • Medical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1780608448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006508-1 Issued in NY
Practice address
6245 Sheridan Dr
Suite 212
Williamsville, NY 14221-4834
Phone
(716) 204-4500
Fax
(716) 204-4501
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 006508-1 NY Primary

Addresses

Primary practice location

6245 Sheridan Dr
Suite 212
Williamsville, NY 14221-4834

Mailing address

6245 Sheridan Dr
Suite 212
Williamsville, NY 14221-4834
Phone (716) 204-4500

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
I20100603000029 NY Practitioner - Physician Assistant 4385773282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

3450 Union Rd
Cheektowaga, NY 14225-5120
Phone (716) 395-2043

4827 Transit Rd
Depew, NY 14043-4788
Phone (716) 771-3394

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6508NYMDFoot & Ankle Surgery Podiatrist
006508-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. Past Accepting new patients
Muncie Allergy Center. P.S.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780608448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 SHERIDAN DR",
            "address_2": "SUITE 212",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214834",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 SHERIDAN DR",
            "address_2": "SUITE 212",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214834",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTENBURG",
        "first_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006508-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.