MRS. BOBBIE RAE FAIVUS VANGORDER (P.A.) – Medical Physician Assistant, NPI 1154630366
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,244 PHYSICIAN ASSISTANT in NY
Provider Addresses for MRS. BOBBIE RAE FAIVUS VANGORDER (P.A.)
1 College Plaza
Oswego, NY 131261731
Phone: (315) 342-0030
Fax: (315) 342-0258
Type: Location
1 COLLEGE PLAZA
OSWEGO, NY 131261731
Phone: (315) 342-0030
Fax: (315) 342-0258
Type: Mailing
110 W UTICA ST
OSWEGO, NY 131263047
Phone: (315) 349-5537
Type: Location
110 W 6TH ST
OSWEGO, NY 131262507
Phone: (315) 349-5511
Fax: (315) 349-5921
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 129 Open Payments records for all available years, with a total value of $2,249.
Total Amount is formed as General ($2,249) + Research ($0) + Ownership ($0) = $2,249.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($382).
Total Amount
$2,249
General + Research + Ownership
Payments
129
Total payment records
General Amount
$2,249
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $382 |
| Lilly USA, LLC | $310 |
| GlaxoSmithKline, LLC. | $199 |
| AstraZeneca Pharmaceuticals LP | $177 |
| Novo Nordisk Inc | $153 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-02-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110209001023 | I | Physician Assistant | NY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 148 | 117 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 140 | 94 | $0 |
| 81003 | Automated urinalysis test | 87 | 72 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 53 | 52 | $0 |
| 82570 | Creatinine level to test for kidney function or muscle injury | 47 | 42 | $0 |
Insurance plans in this area (ZIP 13126)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | NY | 83036 | Hemoglobin A1C level | 25 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NY | |
| Physician Assistant | NY | |
| Physician Assistant | NY | |
| - | NY | |
| Physician Assistant | NY | |
| General Surgery | PA | |
| Physician Assistant | NY | |
| Orthopedic Surgery | NY | |
| Nurse Practitioner | NY | |
| Family Practice | NY |
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