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

Charles Vollmoeller, PA

Individual provider Physician Assistant · NPI 1356867808

Charles Vollmoeller, PA is a Physician Assistant in West Islip, New York. Qualified in 2017, 9 years ago. Practices with Fast Pace Medical Clinic PLLC, a 738-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and Tennessee.

Years since qualifying
9
Licensed in
NY, TN
In the registry since
2017
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

1111 Montauk Hwy Ste 3
West Islip, NY 11795-4910
Phone: (631) 669-1171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 910 New Highway 68, Sweetwater, TN 37874-2729 — (423) 836-9304

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 021163 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 6626 (TN)

Record details

NPI number1356867808
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 16, 2017
Last updated in NPPESAugust 22, 2025
Certification dateAugust 22, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Fast Pace Medical Clinic Pllc — 738 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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