Individual provider Active NPI

Olivia D Myers, MS, PA-C

  • Physician Assistant
  • Liverpool, NY
National Provider Identifier
1215626353
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030449 Issued in NY
Practice address
8687 Carling Rd
Liverpool, NY 13090-1315
Phone
(315) 473-3700
NPI assigned
May 4, 2023
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 030449 NY Primary

Addresses

Primary practice location

8687 Carling Rd
Liverpool, NY 13090-1315

Mailing address

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

Other practice location 1

4900 Broad Road
Syracuse, NY 13215
Phone (315) 492-5899

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
I20231221001857 NY Practitioner - Physician Assistant 2062862717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Dec 7, 2023 Accepting new patients
Physical Medicine & Rehab Medical Service Group PastSince Sep 28, 2025 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

8687 Carling Rd
Liverpool, NY 13090
Phone (315) 464-6543

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

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

Interoperability endpoints

  • Direct secure messaging: omyers148980@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.

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1215626353",
    "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": "8687 CARLING RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901315",
            "telephone_number": "315-473-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Broad Road",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "13215",
            "country_code": "US",
            "telephone_number": "315-492-5899",
            "fax_number": "315-492-5627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "OLIVIA",
        "middle_name": "D",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.