Individual provider Active NPI

Makala Mae Stevens, PA-C

  • Physician Assistant
  • Oswego, NY
National Provider Identifier
1811865405
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
110 W 6TH St
Oswego, NY 13126-2598
Phone
(315) 349-5522
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

110 W 6TH St
Oswego, NY 13126-2598

Mailing address

8360 Cooper Rd
Weedsport, NY 13166-9805

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
I20260304004145 NY Practitioner - Physician Assistant 4880176296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients

Locations

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Organizations & group practices 3

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": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1811865405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8360 COOPER RD",
            "city": "WEEDSPORT",
            "state": "NY",
            "postal_code": "131669805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262598",
            "telephone_number": "315-349-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MAKALA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.