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

Individual provider Medical Physician Assistant · NPI 1053042077

Luke Alexander Gillis, PA-C is a Physician Assistant in Potsdam, New York. Qualified in 2022, 4 years ago. Practices with Nc Emergency Physician Services PLLC, a 15-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and New York.

Years since qualifying
4
Licensed in
NC, NY
In the registry since
2022
Specialties on file
2
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 13676-1799
Phone: (315) 265-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 233 Gilmer St, Reidsville, NC 27320-3809 — (336) 342-6196

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 10010-14575 (NC)

Record details

NPI number1053042077
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 21, 2022
Last updated in NPPESNovember 20, 2025
Certification dateNovember 20, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Nc Emergency Physician Services Pllc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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