Individual provider Active NPI

Benjamin Craxton, MD

  • Emergency Medicine Physician
  • Syracuse, NY
National Provider Identifier
1063941433
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
303286 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203
Phone
(315) 448-5536
NPI assigned
Jun 8, 2017
Last updated
May 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 303286 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, LA, FL, PA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20200504000982 NY Practitioner - Emergency Medicine 4284065426 Reassigns benefits to 2 organizations
I20231222000782 LA Practitioner - Emergency Medicine 4284065426 Reassigns benefits to 1 organization
I20240429000827 FL Practitioner - Family Practice 4284065426
I20250520004791 PA Practitioner - Family Practice 4284065426

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mylaurel Medical Group la, LLCGroup PAC ID 8123365467, 15 clinicians
Mylaurel Medical Group Ny, PLLCGroup PAC ID 7618349044, 14 clinicians

Practice addresses (Care Compare)

824 Elmwood Park Blvd
Suite 135
Harahan, LA 70123-3337
Phone (504) 370-9966

949 48TH St
Brooklyn, NY 11219-2919
Phone (702) 417-6255

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mylaurel Medical Group la, LLC CurrentSince Dec 11, 2023 Accepting new patients
Mylaurel Medical Group Ny, PLLC Emergency Medicine CurrentSince Jul 2, 2023 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Virta Medical P.C. PastSince Apr 14, 2025 Accepting new patients
Mylaurel Medical Group NJ, PC PastSince Dec 17, 2023 Accepting new patients

Locations

824 Elmwood Park Blvd
Ste 135
New Orleans, LA 70123
Phone (504) 266-2576

949 48th St
Brooklyn, NY 11219
Phone (702) 417-6255

885 3rd Ave
Fl 29
New York, NY 10022
Phone (866) 603-7803

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: bcraxton2180880@direct.ochsner.org
  • Direct secure messaging: benjamin.craxton.1@25238.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1063941433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-448-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAXTON",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "303286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.