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

Elly Wagner, PA-C

Individual provider Physician Assistant · NPI 1629859426

Elly Wagner, PA-C is a Physician Assistant in Kingston, New York. Qualified in 2023, 3 years ago. Practices with Westchester Medical Center Advanced Physician Services PC, a 880-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023
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

373 Broadway
Kingston, NY 12401-5151
Phone: (845) 303-1132
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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 030799 (NY)

Record details

NPI number1629859426
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 9, 2023
Last updated in NPPESOctober 9, 2023
Certification dateOctober 9, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Westchester Medical Center Advanced Physician Services Pc — 880 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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