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

Shadoe M Daniels, MPAS, PA-C

Individual provider Medical Physician Assistant · NPI 1215596317

Shadoe M Daniels, MPAS, PA-C is a Physician Assistant in Callicoon, New York. Qualified in 2019, 7 years ago. Practices with Cooperstown Medical Center, a 12-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in North Dakota, New York and Pennsylvania.

Years since qualifying
7
Licensed in
ND, NY, PA
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

8881 NY-97
Callicoon, NY 12723
Phone: (845) 333-6800
Show map & directions

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

Additional practice locations (4)

  • 107 12th St S, Cooperstown, ND 58425-4501 — (701) 786-1700
  • 707 E Main St, Middletown, NY 10940-2650 — (845) 333-1000
  • 68 Harris Bushville Rd, Monticello, NY 12701-3027 — (845) 794-3300
  • 575 N River St, Wilkes Barre, PA 18702-2634 — (570) 829-8111

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 024896 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PAC0965 (ND)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA060726 (PA)

Record details

NPI number1215596317
Entity typeIndividual (Type 1)
GenderMale
Credentials MPAS , PA-C
Sole proprietorNo
NPI enumeratedJune 12, 2019
Last updated in NPPESAugust 29, 2024
Certification dateAugust 29, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Cooperstown Medical Center — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare