William Henry Niemeyer III, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-001528 Issued in IL

Practice address

385 W Main St
Avon, CT 06001-4357

Phone

(860) 777-1280

NPI assigned

Jun 13, 2006

Last updated

Sep 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, MA, RI, CT4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.niemeyer.1@14940.direct.athenahealth.com
• Direct secure messaging: wniemeyer44358@direct.med.uchc.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Brookline, MA
  • NPI 1720486830
  Medicare reassignment NPD
• Colchester Urgent Care Center LLC

  dba The Urgent Care of Colchester

  • Family Medicine Physician
  • Colchester, CT
  • NPI 1225702566
  Medicare reassignment
• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment
• University of Connecticut Health Center

  dba University Physicians

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769
  Medicare reassignment
• Ambucare Clinic

  • Family Medicine Physician
  • Terre Haute, IN
  • NPI 1013907922
  Medicare reassignment
• Emergency Care Services of New England PC

  • Emergency Medicine Physician
  • North Providence, RI
  • NPI 1639537335
  Medicare reassignment
• VMD Primary Providers of Rhode Island PC

  • Family Medicine Physician
  • Cumberland, RI
  • NPI 1598341067
  Medicare reassignment
• University of Connecticut Health Center

  dba University Physicians

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1104809375
  NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1609387695
  NPD
• Aakaish Sanjeevi Home Health Physicians

  • Family Medicine Physician
  • Colchester, CT
  • NPI 1023976636
  NPD (past)
• Illiana Emergency Physicians LLP

  • Emergency Medicine Physician
  • Greenville, IL
  • NPI 1730426941
  NPD (past)
• Illiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1164447058

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1861435679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 ASHLEY DRIVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014357",
            "telephone_number": "860-777-1280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "RI",
            "postal_code": "028063430",
            "country_code": "US",
            "telephone_number": "401-903-0300",
            "fax_number": "401-337-5357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 E Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213803",
            "country_code": "US",
            "telephone_number": "317-364-0833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMEYER",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01134",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "004173",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LIC",
            "identifier": "004173",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EClinicalWorks",
            "affiliation": "N",
            "address_1": "310 Maple Ave",
            "city": "Barrington",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028063430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Newleaf Behavioral Health Partners LLC
• Newpoint Family Dental LLC
• Nam V Nguyen, PA
• Caroline Nicholas-Brunetto, APRN
• Laura Nicklis, DPT
• Jenna Marie Tellerico Niles, MS CCC-SLP
• Renata Niziolek, PSYD.
• Rachel Candace Noia, M.S. CCC-SLP
• Jayna Noreikis, APRN, FNP-C
• North Haven Arch Supports (Good Feet)

• Physician Assistant in Avon, CT
• Providers in Avon, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.