Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carolyn Rose Fon, PA

Individual provider Physician Assistant · NPI 1861229791

Carolyn Rose Fon, PA is a Physician Assistant in Vestal, New York. Qualified in 2024, 2 years ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York and Pennsylvania.

Years since qualifying
2
Licensed in
NY, PA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3101 Shippers Rd Ste 203
Vestal, NY 13850-2082
Phone: (607) 786-4822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 032664 (NY)
Physician Assistant Taxonomy 363A00000X · Licence MA065946 (PA)

Record details

NPI number1861229791
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 16, 2024
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Vestal