Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Brandon James Formoza, PA-C

Individual provider Physician Assistant · NPI 1700778446

Brandon James Formoza, PA-C is a Physician Assistant in Potsdam, New York. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

50 Leroy St
Potsdam, NY 13676-1786
Phone: (585) 236-0373
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Hospital Dr, Massena, NY 13662-1056 — (585) 236-0373

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 034031 (NY)

Record details

NPI number1700778446
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 17, 2025
Last updated in NPPESJuly 17, 2025
Certification dateJuly 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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