Individual provider Active NPI

Melissa Ann Thomas, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1932270196
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009120-1 Issued in NY
Practice address
4900 Broad Rd
Community General Hospital ER Dept
Syracuse, NY 13215-2265
Phone
(315) 492-5664
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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 009120-1 NY Primary

Addresses

Primary practice location

4900 Broad Rd
Community General Hospital ER Dept
Syracuse, NY 13215-2265

Mailing address

325 Melvin Dr
North Syracuse, NY 13212-4221
Phone (315) 457-1923

Other identifiers 1

IdentifierTypeStateIssuer
02354016MedicaidNY

Other names 1

  • Melissa Anne Macewicz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI, PA, IL, IN5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20040802000571 NY Practitioner - Physician Assistant 6709857170 Reassigns benefits to 1 organization
I20260331002047 MI Practitioner - Physician Assistant 6709857170 Reassigns benefits to 1 organization
I20260414000543 PA Practitioner - Physician Assistant 6709857170 Reassigns benefits to 1 organization
I20260422002007 IL Practitioner - Physician Assistant 6709857170 Reassigns benefits to 1 organization
I20260521004191 IN Practitioner - Physician Assistant 6709857170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14 Bristol Lane
Ellicohville, NY 14731-0500

PO Box
Suite 500
Ellicottville, NY 14731-0500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009120-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chung Hyun Oh MD PC Past Accepting new patients
Onondaga Hill E R Physicians, LLP Past Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Ny Urgent Care Practice, P.C. Past Accepting new patients

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1932270196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MELVIN DR",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124221",
            "telephone_number": "315-457-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "address_2": "COMMUNITY GENERAL HOSPITAL ER DEPT",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009120-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02354016",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MACEWICZ",
            "middle_name": "ANNE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.