Jessica Walsh, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014704 Issued in NY

Practice address

2125 River Rd
Suite 100
Niskayuna, NY 12309-1135

Phone

(518) 836-3030

Fax

(518) 836-3020

NPI assigned

Apr 12, 2011

Last updated

Apr 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jessica Schnell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jwalsh834404@direct.trinity-health.org

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1922398916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "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",
            "address_2": "SUITE 100",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123091135",
            "telephone_number": "518-836-3030",
            "fax_number": "518-836-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03433043",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SCHNELL",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Niskayuna, NY
• Providers in Niskayuna, 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 Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.