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

Shanise Thomas

Individual provider Physician Assistant · NPI 1023647013

Shanise Thomas is a Physician Assistant in Ithaca, New York. Qualified in 2020, 6 years ago. Practices with Cayuga Medical Associates PC, a 277-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

16 Brentwood Dr Ste A
Ithaca, NY 14850-1863
Phone: (607) 272-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 108 Sapsucker Woods Rd Apt 2a, Ithaca, NY 14850-1979 — (607) 207-6738

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 025928 (NY)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1023647013
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 2, 2020
Last updated in NPPESNovember 11, 2020
Certification dateNovember 11, 2020
Mailing address16 Brentwood Dr Ste A, Ithaca, NY 14850-1863

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Cayuga Medical Associates Pc — 277 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Ithaca