MRS. BOBBIE RAE FAIVUS VANGORDER P.A.
NPI 1154630366
Physician Assistant - Medical in Oswego, NY

Q: What is Bobbie Rae Vangorder's NPI number?

The NPI number for Bobbie Rae Vangorder is 1154630366. It was assigned to this individual provider in the NPPES registry on October 5, 2010.

Q: What is Bobbie Rae Vangorder's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since October 05, 2010PECOS EnrolledAccepts Medicare Assignment

110 W UTICA ST, OSWEGO, NY 13126(315) 349-5537 Get Directions Write a Review

NPPES record last updated: March 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 29, 2023, Sep 11, 2020 (2 updates tracked since 2020).

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About Mrs. Bobbie Rae Faivus Vangorder P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. BOBBIE RAE FAIVUS VANGORDER P.A. (NPI 1154630366) is an individual medical provider in Oswego, New York, licensed in New York (014226) and active in the NPI registry since October 2010. She is enrolled in Medicare PECOS, is affiliated with Oswego Hospital, and maintains a secondary practice location in Oswego.

NPPES Registry Identity

NPI1154630366

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. BOBBIE RAE FAIVUS VANGORDERCredential: P.A.

Location Address110 W UTICA STOswego, NY 13126-3047

Mailing Address110 W 6th StOswego, NY 13126-2507 · (315) 349-5511 · Fax (315) 349-5921

Phone(315) 349-5537

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateOctober 5, 2010

Last NPPES UpdateMarch 29, 20232 updates tracked since enumeration

NPPES CertifiedMarch 29, 2023

✔ NPI 1154630366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NY · 014226

110 W UTICA ST, Oswego, NY 13126

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Secondary Practice Location 1

Location 11 College PlazaOswego, NY 13126-1731 · Phone (315) 342-0030 ext. 102 · Fax (315) 342-0258

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Bobbie Rae Faivus Vangorder P.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567642457

PECOS Enrollment IDI20110209001023

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

142 services87 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

128 services93 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

79 services69 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

52 services49 patients

Urine microalbumin (protein) analysis 82044

Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.

47 services44 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

46 services46 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Oswego Hospital

Acute Care Hospitals · Oswego, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330218

Location110 West Sixth StreetOswego, NY 13126 · Oswego County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$19.50 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$109.33 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMIE WALLACE NP

Nurse Practitioner (Family)