Casey Pettit, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

015512 Issued in NY

Practice address

608 William St
Buffalo, NY 14206-1649

Phone

(716) 668-7051

Fax

(716) 668-7069

NPI assigned

Jan 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: casey.pettit@erie.gov

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.

• County of Erie Comptrollers Office

  • Public Health or Welfare Agency
  • Buffalo, NY
  • NPI 1134210313
  Medicare reassignment NPD

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1821368291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 WILLIAM ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142061649",
            "telephone_number": "716-858-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WILLIAM ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142061649",
            "telephone_number": "716-668-7051",
            "fax_number": "716-668-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "CASEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Casey.Pettit@erie.gov",
            "affiliation": "N",
            "address_1": "608 William St",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142061649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Petroziello, MD
• Mariah Lee Petrusek, R.D.N.
• Anita Petrushenko
• Mary Jane Petruzzi, MD
• Camille Frances Petti, LMSW
• Coleman Pettway Jr.
• Reshawna Petty
• Tamika Shawntrice Petty, LPN
• Carolyn Pettys, RPH
• Matthew Michael Peunil Jr., RPH

• Physician Assistant in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.