Active NPI
Gregory C Sy, PA
- Physician Assistant
- Bethel, AK
National Provider Identifier
1144241472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1058
- Practice address
- 700 Chief Eddie Hoffman Hwy
Bethel, AK 99559 - Phone
- (907) 543-6300
- NPI assigned
- Jul 21, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA702 | KY | |
| Physician Assistant | 363A00000X | 1058 | AK | Primary |
Addresses
Primary practice location
700 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Mailing address
P.O. Box 258
700 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Phone (907) 543-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95005674 | Medicaid | KY |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1058 | AK | MD | General Practice Dentistry |
| PA702 | KY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1144241472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 258",
"address_2": "700 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SY",
"first_name": "GREGORY",
"middle_name": "C",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA702",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "1058",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95005674",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.