Individual provider Active NPI

Tatyana Belous, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1194354241
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025973 Issued in NY
Practice address
739 Irving Ave Ste 340
Syracuse, NY 13210-1605
Phone
(315) 470-7747
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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 025973 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 340
Syracuse, NY 13210-1605

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

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
I20210517001353 NY Practitioner - Physician Assistant 5991114217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-7111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice, PLLC Medical CurrentSince Mar 27, 2023 Accepting new patients
Crouse Health Inc. PastSince Apr 6, 2023 Accepting new patients
Familycare Medical Group, PC Physician Assistant PastSince Apr 1, 2022 Accepting new patients
Lake Ontario Prompt Medical Care, PLLC PastSince Apr 30, 2023 Accepting new patients

Locations

739 Irving Ave
Syracuse, NY 13210
Phone (315) 470-2951

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

739 Irving Ave
Ste 340
Syracuse, NY 13210
Phone (315) 470-7747

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 471-0190

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1194354241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 340",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101605",
            "telephone_number": "315-470-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOUS",
        "first_name": "TATYANA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.