MR. DAVID EUGENE TISDALE (NPI# 1396835112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396835112 |
| Entity Type | Individual |
| Full Name | MR. DAVID EUGENE TISDALE |
| Credential | R-PCA |
| Practice Address |
1 Hospital Dr Massena NY 13662-1056 |
| Practice Telephone | 3157694200 |
| Mailing Telephone | 3157694200 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 002506 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | PA LISCENCE | 02506 | 01 |
| NY | 03773219 | 05 |
| Street Address |
1 HOSPITAL DR |
| City | MASSENA |
| State | NY |
| Zip Code | 13662-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093368615 | Katherine Daigneault | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2019-07-23 |
| 1831654219 | David Lawrence Mccarthy | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2019-02-09 |
| 1174013197 | Brenda L Crowder | Physician Assistant | 1 Hospital Dr, Massena, NY 13662 | 2018-05-15 |
| 1902348816 | Houman Farzin | General Practice | 1 Hospital Dr, Massena, NY 13662-1056 | 2016-11-08 |
| 1861891814 | Pamela Sue Leary | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2014-08-15 |
| 1689080475 | Wai Kyaw | Hospitalist | 1 Hospital Dr, Massena, NY 13662-1056 | 2014-07-01 |
| 1427478759 | Mona Chapman | Speech-Language Pathologist | 1 Hospital Dr, Massena, NY 13662-1056 | 2014-04-25 |
| 1720401318 | Myo S Win | Internal Medicine | 1 Hospital Dr, Massena, NY 13662-1056 | 2014-02-03 |
| 1154753945 | Carol R Miller | Nurse Practitioner | 1 Hospital Dr, Massena, NY 13662-1056 | 2013-08-02 |
| 1568714905 | Elizabeth Joan Morgan | Nutritionist | 1 Hospital Dr, Massena, NY 13662-1056 | 2012-10-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437796380 | Emily Lashomb | Physical Medicine & Rehabilitation | Mmh Outpatient Center/pt, 271 Andrews St, Suite 269, Massena, NY 13662 | 2019-12-10 |
| 1689059727 | Cassandra Lynn Lashomb | Physician Assistant | St Lawrence University, 23 Romoda Drive, Canton, NY 13662 | 2015-07-29 |
| 1497163885 | Ryan Normal Degon | Specialist/Technologist | Park Avenue East, Work-fit At Alcoa Massena Operations, Massena, NY 13662 | 2014-07-29 |
| 1821419839 | Beverly Elaine Eastwood | Registered Nurse | 25 Owl Avenue, Madison Elementary School, Massena, NY 13662 | 2013-12-17 |
| 1083969117 | David Disalvo | Physical Therapist | Mh Outpatient Ctr/physical Therapy, 271 Andrews St, Suite 269, Massena, NY 13662 | 2012-07-15 |
| 1710205935 | Robin G Taylor | Counselor | 221 Harrowgate Commons, Massena, NY 13662 | 2010-05-12 |
| 1821291295 | Amanda Leigh Allen | Pharmacist | 303 Main St., Massena, NY 13662 | 2007-06-06 |
| 1255450664 | Cheryll A Terrance | Counselor | 27 Brighton St, Massena, NY 13662 | 2007-03-28 |
| 1033238704 | Richard C Summermatter | Obstetrics & Gynecology | North Country Women's Health, 15 Hospital Dr, Massena, NY 13662 | 2007-03-27 |
| 1356480610 | Joan Sharon Delarm | Social Worker | 74 Andrews St, Massena, NY 13662 | 2007-02-05 |
| Find all providers in zip 13662 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447775036 | Joseph P Salamy | Physician Assistant | 271 Andrews St Ste 267, Massena, NY 13662-3401 | 2017-08-04 |
| 1992861728 | Cosette Anne Witty-lewis | Physician Assistant | 10 State Highway 37b, Massena, NY 13662-3142 | 2006-12-28 |
| 1093368615 | Katherine Daigneault | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2019-07-23 |
| 1831654219 | David Lawrence Mccarthy | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2019-02-09 |
| 1174013197 | Brenda L Crowder | Physician Assistant | 1 Hospital Dr, Massena, NY 13662 | 2018-05-15 |
| 1861891814 | Pamela Sue Leary | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2014-08-15 |
| 1134147333 | Amanda Rydberg | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2006-07-17 |
| 1184606980 | Joseph R Lamb | Physician Assistant | 1 Hospital Dr, Massena, NY 13662-1056 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821026 | Victoria Yunaev | Physician Assistant | 7203 166th St, Fresh Meadows, NY 11365-3237 | 2020-11-05 |
| 1811598857 | Brittany Christine Androsko | Physician Assistant | 1769 Union St Fl 2, Niskayuna, NY 12309-6311 | 2020-11-05 |
| 1164023172 | Betina Charlotte Apostol Nuguid | Physician Assistant | 1730 Central Park Ave Ste 3p, Yonkers, NY 10710-4905 | 2020-11-05 |
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1205437621 | Jason Patrick Feak | Physician Assistant | 6338 Falls Blvd, Chittenango, NY 13037-8799 | 2020-11-03 |
| 1437750742 | Drew James Mitchell | Physician Assistant | 58 Old Bedford Rd, Goldens Bridge, NY 10526-1000 | 2020-11-03 |
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1487254330 | Thomas J Nagel | Physician Assistant | 57 Montgomery Road, Fort Montgomery, NY 10922 | 2020-10-29 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.