Individual provider Active NPI

Audrey Hannah Crocker, RPA

  • Physician Assistant
  • Plattsburgh, NY
National Provider Identifier
1922581966
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
75 Beekman St
Plattsburgh, NY 12901-1438
Phone
(518) 562-7371
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

75 Beekman St
Plattsburgh, NY 12901-1438

Mailing address

PO Box 2868
Plattsburgh, NY 12901-0259
Phone (518) 562-7900

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
I20181210000451 NY Practitioner - Physician Assistant 2365786951 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022766NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Community Hospital CurrentSince Dec 1, 2022 Accepting new patients
Elizabethtown Community Hospital CurrentSince Dec 1, 2022 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Physician Assistant CurrentSince Oct 10, 2018 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: acrocker260841@direct.uvmhealth.org

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": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1922581966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010259",
            "telephone_number": "518-562-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-562-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "AUDREY",
        "middle_name": "HANNAH",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.