Individual provider Active NPI

Gyasi Kodua, MD

  • Family Medicine Physician
  • Barneveld, NY
National Provider Identifier
1053007526
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
345996 Issued in NY
Practice address
7980 State Route 12
Barneveld, NY 13304-2540
Phone
(315) 624-8440
Fax
(315) 624-8842
NPI assigned
Apr 17, 2023
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 345996 NY Primary

Addresses

Primary practice location

7980 State Route 12
Barneveld, NY 13304-2540

Mailing address

111 Hospital Dr
Attn:Credentialing
Utica, NY 13502-2517
Phone (315) 624-6101

Other practice location 1

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 624-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
345996NYMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1053007526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "address_2": "ATTN:CREDENTIALING",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022517",
            "telephone_number": "315-624-6101",
            "fax_number": "315-624-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 STATE ROUTE 12",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "133042540",
            "telephone_number": "315-624-8440",
            "fax_number": "315-624-8842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1676 Sunset Ave",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135025416",
            "country_code": "US",
            "telephone_number": "315-624-6241",
            "fax_number": "315-624-6395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODUA",
        "first_name": "GYASI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "345996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barneveld, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.