Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shani A Wilson, RPA-C

Individual provider Medical Physician Assistant · NPI 1477989580

Shani A Wilson, RPA-C is a Physician Assistant in Rochester, New York. Qualified in 2013, 13 years ago. Practices with Ophelia Medical Group Fl PA, a 100-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2013
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Practice location Address checks out

158 Orchard St
Rochester, NY 14611-1361
Phone: (585) 368-4500
Fax: (585) 436-6047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 016834 (NY)

Record details

NPI number1477989580
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA-C
Sole proprietorNo
NPI enumeratedSeptember 20, 2013
Last updated in NPPESDecember 2, 2020
Certification dateNovember 16, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Ophelia Medical Group Fl Pa — 100 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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