Individual provider Active NPI

Mackenzie Cherniuk, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1205567898
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032998 Issued in NY
Practice address
750 East Adams Street
Syracuse, NY 13210
Phone
(315) 464-5910
Fax
(315) 464-1937
NPI assigned
Jun 23, 2022
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 032998 NY Primary
Physician Assistant 363A00000X PA17197 TX

Addresses

Primary practice location

750 East Adams Street
Syracuse, NY 13210

Mailing address

251 Salina Meadows Parkway
Suite 100
Syracuse, NY 13212
Phone (315) 464-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240105003439 TX Practitioner - Physician Assistant 3678924420 Reassigns benefits to 1 organization
I20250909000675 NY Practitioner - Physician Assistant 3678924420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 464-3265

550 Harrison St
Syracuse, NY 13202-3188
Phone (315) 464-8093

713 Harrison St
BLDG 3
Syracuse, NY 13210-2305
Phone (315) 464-3265

719 Harrison St
Syracuse, NY 13210-2305

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-8093

750 E Adams St
Cab Room 320
Syracuse, NY 13210-1834

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032998NYMDPhysician Assistant
PA17197TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group CurrentSince Feb 1, 2024 Accepting new patients
Suny Health Science Center at Syracuse Physician Assistant CurrentSince Jul 24, 2025 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Jul 24, 2025 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Dec 15, 2025 Accepting new patients

Locations

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

Interoperability endpoints

  • Direct secure messaging: mcherniuk133026@direct.upstate.edu

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, 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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1205567898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PARKWAY",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-464-2000",
            "fax_number": "315-464-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5910",
            "fax_number": "315-464-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNIUK",
        "first_name": "MACKENZIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2025-09-02",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032998",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.