Individual provider Active NPI

Christine Alice Doak, PAC

  • Physician Assistant
  • Corning, NY
National Provider Identifier
1942279336
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006588-1 Issued in NY
Practice address
130 Centerway
Corning, NY 14830-2255
Phone
(607) 936-9971
Fax
(607) 936-2600
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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 006588-1 NY Primary

Addresses

Primary practice location

130 Centerway
Corning, NY 14830-2255

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 3

IdentifierTypeStateIssuer
01923720MedicaidNY
970026517OtherNYRR MEDICARE PIN
CC8362OtherNYRR MEDICARE GROUP

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
I20110510000208 NY Practitioner - Physician Assistant 1850577826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006588-1NYMDMetabolic Nutrition Registered Dietitian
0065881NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Feb 25, 2002 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Feb 25, 2002 Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Guthrie Medical Group PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients

Locations

3 Guthrie Dr
Corning, NY 14830
Phone (607) 973-8000

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: cdoakrowling7238@direct-guthrie.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1942279336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CENTERWAY",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302255",
            "telephone_number": "607-936-9971",
            "fax_number": "607-936-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAK",
        "first_name": "CHRISTINE",
        "middle_name": "ALICE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006588-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01923720",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "970026517",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC8362",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, NY

Sources for this page

Verify at the official NPI Registry.