Individual provider Active NPI

Emily Crandell, PA

  • Medical Physician Assistant
  • Oswego, NY
National Provider Identifier
1114476231
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
020182-1 Issued in NY
Practice address
33 E Schuyler St
Oswego, NY 13126-1161
Phone
(315) 342-2024
Fax
(315) 343-5317
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 020182-1 NY Primary

Addresses

Primary practice location

33 E Schuyler St
Oswego, NY 13126-1161

Mailing address

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Other practice location 1

300 State Route 104
Oswego, NY 13126-2956
Phone (315) 342-0030

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216001788 NY Practitioner - Physician Assistant 4880974427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Hospital & facility affiliations

  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020182-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Ontario Prompt Medical Care, PLLC PastSince Apr 30, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ecrandell1@hiemail.healtheconnections.org
  • Direct secure messaging: ecrandell@oswegohealth.medentdirect.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1114476231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511",
            "fax_number": "315-349-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E SCHUYLER ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261161",
            "telephone_number": "315-342-2024",
            "fax_number": "315-343-5317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 State Route 104",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "NY",
            "postal_code": "131262956",
            "country_code": "US",
            "telephone_number": "315-342-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANDELL",
        "first_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020182-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.