Individual provider Active NPI

Patrick Vandermark

  • Student in an Organized Health Care Education/Training Program
  • Webster, NY
National Provider Identifier
1790483758
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1626 Glendowan Ter
Webster, NY 14580-8571
Phone
(585) 645-7917
NPI assigned
Feb 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1626 Glendowan Ter
Webster, NY 14580-8571

Mailing address

1626 Glendowan Ter
Webster, NY 14580-8571
Phone (585) 645-7917

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
I20241204001858 NY Practitioner - Physician Assistant 7719413574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

1238 E Ridge Rd
Rochester, NY 14621-2012
Phone (585) 537-3792

1867 Empire Blvd
Webster, NY 14580-1910
Phone (585) 347-3689

233 Winton Rd N
Rochester, NY 14610-1229
Phone (585) 441-3914

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

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
032795NYMDEndodontist

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1790483758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 GLENDOWAN TER",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145808571",
            "telephone_number": "585-645-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 GLENDOWAN TER",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145808571",
            "telephone_number": "585-645-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMARK",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.