Individual provider Active NPI

Michael Grant O'Rourke, PA-C

  • Physician Assistant
  • Niskayuna, NY
National Provider Identifier
1851742332
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019765 Issued in NY
Practice address
2125 River Rd Ste 303
Niskayuna, NY 12309-1136
Phone
(518) 213-6910
Fax
(518) 213-6915
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 019765 NY
Physician Assistant 363A00000X 019765 NY Primary

Addresses

Primary practice location

2125 River Rd Ste 303
Niskayuna, NY 12309-1136

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other practice location 1

211 Church St Ste 1
Saratoga Springs, NY 12866-1003
Phone (518) 587-3222

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
I20161003001271 NY Practitioner - Physician Assistant 7719274976 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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)

1708 Altamount Ave
Schenectady, NY 12303-2137
Phone (518) 344-4778

445 Balltown Rd
Suite 1
Schenectady, NY 12304-2269
Phone (518) 387-3566

4942 State Hwy 30
Suite 100
Amsterdam, NY 12010-7520
Phone (518) 627-6336

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Jul 25, 2016 Accepting new patients
Saratoga Hospital CurrentSince Jul 25, 2016 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

211 Church St
#1
Saratoga Springs, NY 12866
Phone (518) 583-8304

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

Interoperability endpoints

  • Direct secure messaging: michaelorourke@ccp.allscriptsdirect.net

Organizations & group practices 8

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1851742332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 RIVER RD STE 303",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123091136",
            "telephone_number": "518-213-6910",
            "fax_number": "518-213-6915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Church St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128661003",
            "country_code": "US",
            "telephone_number": "518-587-3222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "MICHAEL",
        "middle_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019765",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niskayuna, NY

Sources for this page

Verify at the official NPI Registry.