Individual provider Active NPI

Erin M Hanley, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Syracuse, NY
National Provider Identifier
1215174347
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
260217 Issued in NY
Practice address
750 E Adams St
Pediatric Emergency Medicine Jacobsen Hall 9TH Floor
Syracuse, NY 13210-2342
Phone
(315) 464-4363
Fax
(315) 464-8690
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 260217 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

750 E Adams St
Pediatric Emergency Medicine Jacobsen Hall 9TH Floor
Syracuse, NY 13210-2342

Mailing address

750 E Adams St
Pediatric Emergency Medicine Jacobsen Hall 9TH Floor
Syracuse, NY 13210-2342
Phone (315) 464-4363

Other identifiers 1

IdentifierTypeStateIssuer
03350209MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000391 NY Practitioner - Emergency Medicine 4587832894 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
260217NYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Emergency Medicine, Inc CurrentSince Jul 1, 2011 Accepting new patients

Locations

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

750 E Adams St
Fl 9
Syracuse, NY 13210
Phone (315) 464-4363

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

Interoperability endpoints

  • Direct secure messaging: ehanley5461@direct.upstate.edu

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1215174347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE JACOBSEN HALL 9TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE JACOBSEN HALL 9TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "ERIN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "260217",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03350209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.