Individual provider Active NPI

Wade Alan Swatsworth, PA-C, MPAS

  • Physician Assistant
  • Fort Drum, NY
National Provider Identifier
1801874995
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11050 Mount Belvedere Blvd
USA Meddac/ Credentials
Fort Drum, NY 13602-5438
Phone
(315) 772-4025
Fax
(315) 772-9498
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 NY Primary

Addresses

Primary practice location

11050 Mount Belvedere Blvd
USA Meddac/ Credentials
Fort Drum, NY 13602-5438

Mailing address

11050 Mount Belvedere Blvd
USA Meddac Attn: Credentials
Fort Drum, NY 13602-5438
Phone (315) 772-4025

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
I20090811000589 NY Practitioner - Physician Assistant 5193879179 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013172NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Area Hospital Inc CurrentSince Feb 27, 2016 Accepting new patients
Carthage Area Hospital, Inc. CurrentSince Feb 7, 2026 Accepting new patients
Carthage Area Hospital Inc CurrentSince Feb 27, 2016 Accepting new patients
Carthage Area Hospital Inc. Past Accepting new patients

Locations

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

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

Organizations & group practices 5

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801874995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "USA MEDDAC ATTN: CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "USA MEDDAC/ CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWATSWORTH",
        "first_name": "WADE",
        "middle_name": "ALAN",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.