| Crouse Medical Practice, Pllc | |
|
736 Irving Ave Syracuse NY 13210-1687 | |
| (315) 470-7375 | |
| Not Available |
| Full Name | Crouse Medical Practice, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 736 Irving Ave, Syracuse, New York |
| Authorized Official Name and Position | Paul Kronenberg (MEMBER) |
| Authorized Official Contact | 3154707375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crouse Medical Practice, Pllc 730 S Crouse Ave Suite 204 Syracuse NY 13210-1754 Ph: (315) 470-7864 | Crouse Medical Practice, Pllc 736 Irving Ave Syracuse NY 13210-1687 Ph: (315) 470-7375 |
| NPI Number | 1922321934 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 09/17/2010 |
| Medicare PECOS PAC ID | 8426189622 |
|---|---|
| Medicare Enrollment ID | O20100702000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922321934 | NPI | - | NPPES |
| 03226395 | Medicaid | NY |
| Provider Name | Albert T Tripodi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871609974 PECOS PAC ID: 7113810664 Enrollment ID: I20040206000663 |
| Provider Name | Martin T Noonan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134235302 PECOS PAC ID: 9032002506 Enrollment ID: I20040206000803 |
| Provider Name | John W Michaels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497717441 PECOS PAC ID: 2264321819 Enrollment ID: I20040312000367 |
| Provider Name | James A Longo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730153453 PECOS PAC ID: 9436044914 Enrollment ID: I20040503000225 |
| Provider Name | William E Schu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548251499 PECOS PAC ID: 6901897214 Enrollment ID: I20040524000856 |
| Provider Name | Stephen M Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841269172 PECOS PAC ID: 0244216729 Enrollment ID: I20040625000440 |
| Provider Name | David Moorthi |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1770586653 PECOS PAC ID: 2466423645 Enrollment ID: I20040802001595 |
| Provider Name | Stephan Alkins |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417954934 PECOS PAC ID: 7618940578 Enrollment ID: I20040818000566 |
| Provider Name | Todd R Lentz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124008347 PECOS PAC ID: 3678549243 Enrollment ID: I20040903001079 |
| Provider Name | Paraskos Araouzos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316938830 PECOS PAC ID: 6002876315 Enrollment ID: I20041012000763 |
| Provider Name | Douglas Zmolek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477534667 PECOS PAC ID: 7113951179 Enrollment ID: I20050920000895 |
| Provider Name | Victor J Croglio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639169162 PECOS PAC ID: 1951202845 Enrollment ID: I20050920000959 |
| Provider Name | Rachna Zirath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023006830 PECOS PAC ID: 7517983810 Enrollment ID: I20051017000295 |
| Provider Name | Nishith Amin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336136860 PECOS PAC ID: 4486568011 Enrollment ID: I20051103000794 |
| Provider Name | Akbar F Ahmed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457359150 PECOS PAC ID: 9931188075 Enrollment ID: I20051108000166 |
| Provider Name | Jeffrey M Desimone |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699726737 PECOS PAC ID: 8820019631 Enrollment ID: I20051208000288 |
| Provider Name | Taewan Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992757421 PECOS PAC ID: 0042233702 Enrollment ID: I20060109000419 |
| Provider Name | Tamas Szombathy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851318208 PECOS PAC ID: 1951306612 Enrollment ID: I20061002000478 |
| Provider Name | Jeanne Pietrzak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679547392 PECOS PAC ID: 5597767855 Enrollment ID: I20070215000448 |
| Provider Name | Mark S Erlebacher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376555417 PECOS PAC ID: 1052411642 Enrollment ID: I20070711000877 |
| Provider Name | Nisha Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578694683 PECOS PAC ID: 1557453602 Enrollment ID: I20070822000457 |
| Provider Name | Sami A Abdul Malak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891835658 PECOS PAC ID: 6204929268 Enrollment ID: I20070906000710 |
| Provider Name | Kenneth A Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518166289 PECOS PAC ID: 7214021286 Enrollment ID: I20070921000041 |
| Provider Name | Natan Khishchenko |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821202441 PECOS PAC ID: 8224128012 Enrollment ID: I20071217000683 |
| Provider Name | Hdayatu Salawu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831379874 PECOS PAC ID: 0749360378 Enrollment ID: I20080108000604 |
| Provider Name | Kwabena A Boahene |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1528032240 PECOS PAC ID: 5890680367 Enrollment ID: I20080714000458 |
| Provider Name | Joseph G Battaglia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720053481 PECOS PAC ID: 6800781378 Enrollment ID: I20080714000574 |
| Provider Name | Anil George |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609073782 PECOS PAC ID: 1254499767 Enrollment ID: I20081027000605 |
| Provider Name | Jeffrey D Ascenzo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699933408 PECOS PAC ID: 7517023583 Enrollment ID: I20090227000335 |
| Provider Name | Thomas S Hartzheim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780635854 PECOS PAC ID: 5092866749 Enrollment ID: I20090619000454 |
| Provider Name | David J Dicesar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1689837734 PECOS PAC ID: 7911058441 Enrollment ID: I20090624000068 |
| Provider Name | Aaron J Sharma |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1568643377 PECOS PAC ID: 8527110014 Enrollment ID: I20090714000562 |
| Provider Name | William P Berkery |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992770606 PECOS PAC ID: 2264327733 Enrollment ID: I20090828000399 |
| Provider Name | Clifford B Soults |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1508858572 PECOS PAC ID: 2769528561 Enrollment ID: I20091008000318 |
| Provider Name | David Y Eng |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1124029210 PECOS PAC ID: 2961541461 Enrollment ID: I20091123000172 |
| Provider Name | Michael L Vertino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861450694 PECOS PAC ID: 0244244150 Enrollment ID: I20100201000031 |
| Provider Name | Seth A Kronenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023013208 PECOS PAC ID: 9931289998 Enrollment ID: I20100203000013 |
| Provider Name | Erik Daly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366447716 PECOS PAC ID: 4385724343 Enrollment ID: I20100203000049 |
| Provider Name | Steven Zygmont |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114965860 PECOS PAC ID: 9931242484 Enrollment ID: I20100205000097 |
| Provider Name | Tammy J Congelli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619927894 PECOS PAC ID: 8123161528 Enrollment ID: I20100208000381 |
| Provider Name | James E Sartori |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295786374 PECOS PAC ID: 7911040316 Enrollment ID: I20100208000403 |
| Provider Name | Caroline W Keib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588669949 PECOS PAC ID: 2668552621 Enrollment ID: I20100210000215 |
| Provider Name | Maria Gigante-baggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356488399 PECOS PAC ID: 8527103605 Enrollment ID: I20100301000130 |
| Provider Name | James Blanchfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538163944 PECOS PAC ID: 2961491824 Enrollment ID: I20100301000562 |
| Provider Name | Debra Buchan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689618498 PECOS PAC ID: 7517002363 Enrollment ID: I20100303001085 |
| Provider Name | Barbara L Clayton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588669964 PECOS PAC ID: 6406991280 Enrollment ID: I20100304000308 |
| Provider Name | Craig T Montgomery |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1578564662 PECOS PAC ID: 6103953377 Enrollment ID: I20100420000336 |
| Provider Name | Evan Belanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528297371 PECOS PAC ID: 5890824338 Enrollment ID: I20100521000636 |
| Provider Name | Brian Keith Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023186061 PECOS PAC ID: 8022100171 Enrollment ID: I20100920000534 |
| Provider Name | Lauri Ann Fairbanks Doane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164597498 PECOS PAC ID: 9931291085 Enrollment ID: I20100921000688 |
| Provider Name | John Gerard Obrien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467527655 PECOS PAC ID: 5395837447 Enrollment ID: I20100921000860 |
| Provider Name | Gregory Canute |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427059880 PECOS PAC ID: 0749241222 Enrollment ID: I20110124000012 |
| Provider Name | Linda S Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043319833 PECOS PAC ID: 9830372531 Enrollment ID: I20110317000467 |
| Provider Name | Nikhil P Joshi |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1962674473 PECOS PAC ID: 3870770357 Enrollment ID: I20110609000548 |
| Provider Name | Heather L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205127156 PECOS PAC ID: 9830369164 Enrollment ID: I20110824000534 |
| Provider Name | Shawn E Fazio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437224755 PECOS PAC ID: 2769574813 Enrollment ID: I20120321000000 |
| Provider Name | David Padalino |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609026137 PECOS PAC ID: 3375709298 Enrollment ID: I20120723000140 |
| Provider Name | Dawn Cassell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265788277 PECOS PAC ID: 0345497574 Enrollment ID: I20120823000378 |
| Provider Name | Erin E Bahamonde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083978993 PECOS PAC ID: 7214186105 Enrollment ID: I20121010000005 |
| Provider Name | Corrie Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205157419 PECOS PAC ID: 8527211226 Enrollment ID: I20130109000004 |
| Provider Name | Andrew P Hathaway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467793273 PECOS PAC ID: 1355588336 Enrollment ID: I20130510000386 |
| Provider Name | Elizabeth G Riccardi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619294279 PECOS PAC ID: 7517101728 Enrollment ID: I20130910000008 |
| Provider Name | Monazza Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538480025 PECOS PAC ID: 7012146756 Enrollment ID: I20140129001384 |
| Provider Name | Joshua W Harrison |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467743484 PECOS PAC ID: 5799901161 Enrollment ID: I20140721000314 |
| Provider Name | Soubhi Azar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457646341 PECOS PAC ID: 0648497701 Enrollment ID: I20140813001340 |
| Provider Name | Kelly A Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528473287 PECOS PAC ID: 2961621149 Enrollment ID: I20140922000330 |
| Provider Name | Charles Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659660710 PECOS PAC ID: 4789805516 Enrollment ID: I20141021000711 |
| Provider Name | John D Cullen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366761991 PECOS PAC ID: 4587885470 Enrollment ID: I20150819008560 |
| Provider Name | Raghu Ramaswamy |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1477861631 PECOS PAC ID: 0244547685 Enrollment ID: I20150916002650 |
| Provider Name | Nola Jean Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649300328 PECOS PAC ID: 1153638580 Enrollment ID: I20150917002191 |
| Provider Name | Teri L Strine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396126298 PECOS PAC ID: 1557679263 Enrollment ID: I20150930000254 |
| Provider Name | Benjamin D Sadowitz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164667960 PECOS PAC ID: 3577872084 Enrollment ID: I20151023001855 |
| Provider Name | Fafa K Xexemeku |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659609006 PECOS PAC ID: 0648435834 Enrollment ID: I20151102002266 |
| Provider Name | Anna N Buckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174990592 PECOS PAC ID: 7315257359 Enrollment ID: I20151104000223 |
| Provider Name | Kamal Gautam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992053250 PECOS PAC ID: 5890005557 Enrollment ID: I20151109001095 |
| Provider Name | Amanda Pero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306151378 PECOS PAC ID: 3274835392 Enrollment ID: I20160106002806 |
| Provider Name | Christine D Kowaleski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700047206 PECOS PAC ID: 4981906799 Enrollment ID: I20160112000340 |
| Provider Name | Tristan D Petrie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548604507 PECOS PAC ID: 5395024798 Enrollment ID: I20161107002179 |
| Provider Name | Tanveer Zamani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710138995 PECOS PAC ID: 2365751252 Enrollment ID: I20170516001270 |
| Provider Name | Amira Goldberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558721373 PECOS PAC ID: 8729386842 Enrollment ID: I20170801001224 |
| Provider Name | John Ulahannan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750539482 PECOS PAC ID: 0840594362 Enrollment ID: I20170823001394 |
| Provider Name | Michelle A Turtschin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598289407 PECOS PAC ID: 8820362650 Enrollment ID: I20170918002899 |
| Provider Name | Dawn Cassell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265788277 PECOS PAC ID: 0345497574 Enrollment ID: I20180316001407 |
| Provider Name | Beverly A Mosher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134536394 PECOS PAC ID: 0446500862 Enrollment ID: I20180906000542 |
| Provider Name | Kevin Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396155511 PECOS PAC ID: 5496067779 Enrollment ID: I20190124003355 |
| Provider Name | Jorge Luis Eller |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083726798 PECOS PAC ID: 7517944820 Enrollment ID: I20190705000439 |
| Provider Name | Christopher Michael Souza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568023612 PECOS PAC ID: 8729317227 Enrollment ID: I20190909002958 |
| Provider Name | Kaylyn E Amuso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386206365 PECOS PAC ID: 5193054302 Enrollment ID: I20190913001599 |
| Provider Name | Henry Joseph Comiter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417039850 PECOS PAC ID: 1658419478 Enrollment ID: I20191022002714 |
| Provider Name | Sophie Alesna-sabang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790149714 PECOS PAC ID: 9234424557 Enrollment ID: I20191029000422 |
| Provider Name | Danielle Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467070490 PECOS PAC ID: 9234556606 Enrollment ID: I20200831001482 |
| Provider Name | Jennifer L Durham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043839285 PECOS PAC ID: 8022436757 Enrollment ID: I20200914000190 |
| Provider Name | Christina Walton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184158206 PECOS PAC ID: 1759628399 Enrollment ID: I20200914001179 |
| Provider Name | Hnin Thandar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366973083 PECOS PAC ID: 6608143920 Enrollment ID: I20201006002490 |
| Provider Name | Naomi Mehmedovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023626793 PECOS PAC ID: 6608296108 Enrollment ID: I20201022001948 |
| Provider Name | Mallory Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265030753 PECOS PAC ID: 6002220738 Enrollment ID: I20210120002769 |
| Provider Name | Svetlana Fomin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326219924 PECOS PAC ID: 4981770591 Enrollment ID: I20210507000555 |
| Provider Name | Patrick R Burke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215384466 PECOS PAC ID: 3274898234 Enrollment ID: I20210513001994 |
| Provider Name | Marsha Ann Mosher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1689234965 PECOS PAC ID: 7911307855 Enrollment ID: I20210614002766 |
| Provider Name | Amanda Marie Kenyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972272136 PECOS PAC ID: 7315335577 Enrollment ID: I20211021000939 |
| Provider Name | Michael Merola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497420947 PECOS PAC ID: 4981092632 Enrollment ID: I20211028002364 |
| Provider Name | Devon Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265195176 PECOS PAC ID: 1254723133 Enrollment ID: I20220127000188 |
| Provider Name | Nicole B Corlyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003582594 PECOS PAC ID: 0143613521 Enrollment ID: I20220207002301 |
| Provider Name | Hassan Elnour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326302894 PECOS PAC ID: 0941596399 Enrollment ID: I20220523000974 |
| Provider Name | Shelby Gambill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356984611 PECOS PAC ID: 6608289863 Enrollment ID: I20221128000962 |
| Provider Name | Steven R Delisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689381683 PECOS PAC ID: 7911364732 Enrollment ID: I20230608002701 |
| Provider Name | Jacob Smiedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407540511 PECOS PAC ID: 0941664023 Enrollment ID: I20230907002075 |
| Provider Name | Jennifer Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336823921 PECOS PAC ID: 3072969351 Enrollment ID: I20231023001572 |
| Provider Name | Clinton Ingersol |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427599604 PECOS PAC ID: 8123397759 Enrollment ID: I20240109002669 |
Updesign Primary Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 812 State Fair Blvd Ste 2a, Syracuse, NY 13209 Phone: 315-256-0490 Fax: 315-887-4240 | |
Suny Upstate Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 90 Presidential Plz, Syracuse, NY 13202 Phone: 315-464-3833 | |
Upstate Family And Preventive Medicine, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 475 Irving Ave, Suite 200, Syracuse, NY 13210 Phone: 315-464-4686 Fax: 315-464-7106 | |
Gianna Of Syracuse Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 127 Chapel Dr., Syracuse, NY 13219 Phone: 585-310-8787 | |
Syracuse Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 S Salina St, Syracuse, NY 13202 Phone: 315-476-7921 | |
St. Camillus Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 813 Fay Rd, Syracuse, NY 13219 Phone: 315-488-2951 Fax: 315-488-7734 | |
Paul S Cohen, Mdpc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 E Genesee St Ste 500, Syracuse, NY 13210 Phone: 315-471-8388 Fax: 315-471-8019 |