Individual provider Active NPI

Janelle Cassidy, PA

  • Medical Physician Assistant
  • Newburgh, NY
National Provider Identifier
1922320696
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013815 Issued in NY
Practice address
1400 Route 300
Newburgh, NY 12550-2995
Phone
(845) 566-6664
Fax
(845) 566-1911
NPI assigned
Feb 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013815 NY Primary

Addresses

Primary practice location

1400 Route 300
Newburgh, NY 12550-2995

Mailing address

1400 Route 300
Newburgh, NY 12550-2995
Phone (845) 566-6664

Other names 1

  • Janelle Cavalli Former name

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
I20101022000165 NY Practitioner - Physician Assistant 8022201086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walk in Medical Urgent Care PCGroup PAC ID 0244497659, 10 clinicians

Practice addresses (Care Compare)

236 S Main St
New City, NY 10956-3318
Phone (845) 678-3434

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013815NYMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Recoverhealth Medical Services, PLLC Past Accepting new patients
Dwell Medical Group PC Past Accepting new patients

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": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1922320696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502995",
            "telephone_number": "845-566-6664",
            "fax_number": "845-566-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502995",
            "telephone_number": "845-566-6664",
            "fax_number": "845-566-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "JANELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANELLE",
            "last_name": "CAVALLI",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.