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

Mrs. Corey E Ennis, PA

Individual provider Physician Assistant · NPI 1912392192

Mrs. Corey E Ennis, PA is a Physician Assistant in Ballston Lake, New York. Qualified in 2015, 11 years ago. Practices with Community Care Physicians PLLC, a 364-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
11
In the registry since
2015
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

1184 State Route 50
Ballston Lake, NY 12019-1923
Phone: (518) 384-1281
Fax: (518) 384-0321
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1912392192
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 3, 2015
Last updated in NPPESOctober 17, 2022
Certification dateOctober 17, 2022
Mailing address711 Troy Schenectady Rd Ste 203, Latham, NY 12110-2461

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Community Care Physicians Pllc — 364 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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