Individual provider Active NPI

Maia Czarnecki, PA

  • Physician Assistant
  • Liverpool, NY
National Provider Identifier
1184077885
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807
Phone
(315) 744-1833
NPI assigned
Jul 18, 2016
Last updated
Jul 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807

Mailing address

5100 W Taft Rd
Suite 1D
Liverpool, NY 13088-3807

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
I20161129001928 NY Practitioner - Physician Assistant 4587944012 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Helio Health IncGroup PAC ID 4789903147, 30 clinicians

Practice addresses (Care Compare)

329 N Salina St
Suite 200
Syracuse, NY 13203-1835
Phone (315) 471-1564

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Jul 5, 2017 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Jul 5, 2017 Accepting new patients
Helio Health, Inc. CurrentSince Dec 9, 2019 Accepting new patients
North Medical PC Current Accepting new patients

Locations

5100 W Taft Rd
Ste 1C
Liverpool, NY 13088
Phone (315) 452-2333

5100 W Taft Rd
Ste 1D
Liverpool, NY 13088
Phone (315) 452-2828

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

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

329 N Salina St
Ste 200
Syracuse, NY 13203

555 E Genesee St
Syracuse, NY 13202
Phone (315) 476-7441

Interoperability endpoints

  • Direct secure messaging: mczarnecki73975@direct.upstate.edu

Organizations & group practices 8

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1184077885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 1D",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 1C",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-744-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "MAIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.