Active NPI
Steven Michael Siracusa, MS,ATC,LAT,CSCS
- Athletic Trainer
- Lafayette, LA
National Provider Identifier
1124477724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATH.200087
- Practice address
- 816 Harding St
Lafayette, LA 70503-2320 - Phone
- (337) 323-3111
- NPI assigned
- Jun 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ATH.200087 | LA | Primary |
| Athletic Trainer | 2255A2300X | AT4050 | TX |
Addresses
Primary practice location
816 Harding St
Lafayette, LA 70503-2320
Mailing address
816 Harding St
Lafayette, LA 70503-2320
Phone (337) 323-3111
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATH.200087 | LA | MD | Athletic Trainer |
| AT4050 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1124477724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 HARDING ST",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705032320",
"telephone_number": "337-323-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 HARDING ST",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705032320",
"telephone_number": "337-323-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRACUSA",
"first_name": "STEVEN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "MS,ATC,LAT,CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "ATH.200087",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT4050",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.