Individual provider Active NPI

Ancy Alexander, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Syracuse, NY
National Provider Identifier
1093395923
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
332666 Issued in NY
Practice address
4900 Broad Road
1St FL
Syracuse, NY 13215
Phone
(315) 492-5437
Fax
(315) 492-5502
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 332666 NY Primary

Addresses

Primary practice location

4900 Broad Road
1St FL
Syracuse, NY 13215

Mailing address

4900 Broad Road
1St FL
Syracuse, NY 13215
Phone (315) 492-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250103003078 NY Practitioner - Pediatric Medicine 0244768281 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
332666NYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Emergency Medicine, Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

4900 Broad Rd
Fl 1
Syracuse, NY 13215
Phone (315) 492-5437

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: aalexander155468@direct.upstate.edu
  • Direct secure messaging: ancy.alexander.p1@direct.mmc.nextgenshare.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1093395923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROAD ROAD",
            "address_2": "1ST FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13215",
            "telephone_number": "315-492-5437",
            "fax_number": "315-492-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD ROAD",
            "address_2": "1ST FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13215",
            "telephone_number": "315-492-5437",
            "fax_number": "315-492-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "ANCY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-01-15",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "332666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.