CROUSE MEDICAL PRACTICE PLLC (NPI# 1568874881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568874881 |
| Entity Type | Organization |
| Organization Name | CROUSE MEDICAL PRACTICE PLLC |
| Other Organization Name | INTERNIST ASSOCIATES OF CENTRAL NEW YORK |
| Practice Address |
739 Irving Ave Suite 200 and 300 Syracuse NY 13210-1651 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 3154795070 |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 195907 | NY | Suppliers |
| Other Name | Type Code |
|---|---|
| Internist Associates of Central New York | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639559305 | Crouse Medical Practice Pllc | Internal Medicine | 739 Irving Ave, Suite 500, Syracuse, NY 13210-1651 | 2015-06-08 |
| 1538500152 | Crouse Medical Practice Pllc | Durable Medical Equipment & Medical Supplies | 475 Irving Ave, Suite 418, Syracuse, NY 13210-1756 | 2013-07-11 |
| 1386990638 | Crouse Medical Practice Pllc | Orthopaedic Surgery | 5823 Widewaters Pkwy, East Syracuse, NY 13057-3081 | 2012-07-24 |
| 1609186006 | Crouse Medical Practice Pllc | Durable Medical Equipment & Medical Supplies | 102 W Seneca St, Manlius, NY 13104-2480 | 2010-10-19 |
| 1184933848 | Crouse Medical Practice Pllc | Durable Medical Equipment & Medical Supplies | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2010-09-29 |
| 1548579212 | Crouse Medical Practice Pllc | Clinical Medical Laboratory | 739 Irving Ave, Suite 350, Syracuse, NY 13210-1651 | 2010-09-29 |
| Street Address |
739 IRVING AVE SUITE 200 AND 300 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384004 | Brenda A Baker | Nurse Practitioner | 739 Irving Ave, Ste 520, Syracuse, NY 13210-1663 | 2005-05-31 |
| 1538604053 | Darren Kwee | Physician Assistant | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2016-12-20 |
| 1093268153 | Mackenzie Renee Rotella | Nurse Practitioner | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2016-07-25 |
| 1811348642 | Sara Finney | Physician Assistant | 739 Irving Ave, Suite 600, Syracuse, NY 13210-1651 | 2016-06-22 |
| 1174990592 | Anna Buckman | Nurse Practitioner | 739 Irving Ave, Suite 500, Syracuse, NY 13210-1651 | 2015-09-02 |
| 1073999769 | Carly Hornis | Obstetrics & Gynecology | 739 Irving Ave, Suite 530, Syracuse, NY 13210-1663 | 2015-08-04 |
| 1144604117 | Brandy Leary | Nurse Practitioner | 739 Irving Ave, Suite 450, Syracuse, NY 13210-1651 | 2015-07-19 |
| 1639559305 | Crouse Medical Practice Pllc | Internal Medicine | 739 Irving Ave, Suite 500, Syracuse, NY 13210-1651 | 2015-06-08 |
| 1477950400 | Tabatha Jorgensen | Physician Assistant | 739 Irving Ave, Suite 600, Syracuse, NY 13210-1651 | 2014-11-19 |
| 1427487412 | Shikela Giles | Nurse Practitioner | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2013-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1205237914 | Family Care Medical Group PC | Non-Pharmacy Dispensing Site | 1304 Buckley Rd, Suite 302, Syracuse, NY 13212-4311 | 2014-09-12 |
| 1225459175 | Familycare Medical Group PC | Non-Pharmacy Dispensing Site | 182 Intrepid Ln, Syracuse, NY 13205-2545 | 2013-12-19 |
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| 1588180343 | Incubizness, Inc. | Non-Pharmacy Dispensing Site | 717 Church St, Medina, NY 14103-1618 | 2017-08-14 |
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| 1134585292 | Applied Sciences Edi Corp | Non-Pharmacy Dispensing Site | 3825 Bell Blvd, Bayside, NY 11361-3368 | 2016-01-05 |
| 1790168656 | Otc Mobile Stores | Non-Pharmacy Dispensing Site | 600 E 132nd St, Bronx, NY 10454-4639 | 2015-07-09 |
| 1235520271 | Allied Medical and Diagnostic Services, Dispensary | Non-Pharmacy Dispensing Site | 1410 Broadway, 23rd Floor, New York, NY 10018 | 2015-02-12 |
| 1083012348 | Add 2 Subtract LLC | Non-Pharmacy Dispensing Site | 22 Legendary Cir, Rye Brook, NY 10573-1077 | 2014-12-18 |
| 1912302233 | Performance Medical Services Pllc | Non-Pharmacy Dispensing Site | 70 E 55th St, 2nd Fl., New York, NY 10022-3222 | 2014-10-29 |
| 1346568730 | Hero Direct Inc | Non-Pharmacy Dispensing Site | 889 Waverly Ave, Holtsville, NY 11742-1109 | 2010-05-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.