Active NPI
Charles A Lindsey, P.A.
- Surgical Physician Assistant
- Ithaca, NY
National Provider Identifier
1972505188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 003099
- Practice address
- 1301 Trumansburg Rd
Ste E
Ithaca, NY 14850-1397 - Phone
- (607) 273-3161
- Fax
- (607) 273-4979
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 003099 | NY | Primary |
Addresses
Primary practice location
1301 Trumansburg Rd
Ste E
Ithaca, NY 14850-1397
Mailing address
6256 Route 41
Homer, NY 13077
Phone (607) 273-3161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1271434 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003099 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323648000000",
"number": "1972505188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6256 ROUTE 41",
"city": "HOMER",
"state": "NY",
"postal_code": "13077",
"telephone_number": "607-273-3161",
"fax_number": "607-273-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 TRUMANSBURG RD",
"address_2": "STE E",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501397",
"telephone_number": "607-273-3161",
"fax_number": "607-273-4979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDSEY",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2011-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "003099",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1271434",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.