Individual provider Active NPI

Cosette Anne Witty-Lewis, PA-C

  • Physician Assistant
  • Massena, NY
National Provider Identifier
1992861728
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004525 Issued in NY
Practice address
10 State Highway 37B
Massena, NY 13662-3142
Phone
(315) 769-4340
Fax
(315) 769-4675
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 004525 NY Primary

Addresses

Primary practice location

10 State Highway 37B
Massena, NY 13662-3142

Mailing address

1 Hospital Dr
Massena, NY 13662-1056
Phone (315) 769-4200

Other identifiers 2

IdentifierTypeStateIssuer
03372598MedicaidNY
004525OtherNYLICENSE #

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
I20041117000483 NY Practitioner - Physician Assistant 0446214621 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4525NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Massena Hospital, Inc CurrentSince Mar 13, 2020 Accepting new patients

Locations

10 State Highway 37B
Massena, NY 13662
Phone (315) 514-1330

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Interoperability endpoints

  • Direct secure messaging: witco@hiemail.healtheconnections.org

Organizations & group practices 2

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992861728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621056",
            "telephone_number": "315-769-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STATE HIGHWAY 37B",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136623142",
            "telephone_number": "315-769-4340",
            "fax_number": "315-769-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTY-LEWIS",
        "first_name": "COSETTE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03372598",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "004525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massena, NY

Sources for this page

Verify at the official NPI Registry.