John Riordan Stulb, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016043 Issued in NY

Practice address

739 Irving Ave Ste 600
Syracuse, NY 13210

Phone

(315) 701-2550

Fax

(315) 701-2551

NPI assigned

Sep 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Crouse Medical Practice, PLLC

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1922321934
  Medicare reassignment Care Compare group NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment Care Compare group
• Crouse Medical Practice PLLC

  • Clinical Medical Laboratory
  • Syracuse, NY
  • NPI 1548579212
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1225389505",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-701-2550",
            "fax_number": "315-701-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4038 West Rd",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "NY",
            "postal_code": "130451842",
            "country_code": "US",
            "telephone_number": "607-758-3008",
            "fax_number": "607-758-3019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULB",
        "first_name": "JOHN",
        "middle_name": "RIORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstulb@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 600",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "13210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter J Stubbs, MD
• Diana Stuber
• Susan K Stuck, PA
• Sue A Stucker, NP
• Bonita Marie Stuhlmiller, RN
• Clark Edmon Stull, LMT
• Laura Alice Stumhofer
• Stacy Sturdevant, LMSW
• Molly A Stuttler-James
• Anita Stynes

• Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.