MEDICARE: CALISTA MARY WINDERS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1518899822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALISTA MARY WINDERS PA-C

Provider Business Mailing Address
First Line	:	510 TOWNE DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-1331
Country	:	US
Telephone Number	:	315-663-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 TOWNE DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-1331
Country	:	US
Telephone Number	:	315-663-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ CALISTA MARY WINDERS PA-C” Practice Location

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