Individual provider Active NPI

Susan K Stuck, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1235394388
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012641 Issued in NY
Practice address
750 East Adams Street
Syracuse, NY 13210
Phone
(315) 464-8035
Fax
(315) 464-5108
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6027 GA
Medical Physician Assistant 363AM0700X 23012641 NY
Medical Physician Assistant 363AM0700X 012641 NY
Physician Assistant 363A00000X 012641 NY Primary

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 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
I20161017002040 NY Practitioner - Physician Assistant 1658532775 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.3 of 100Reported as group
Quality
98.32
Promoting interoperability
100
Improvement activities
40
Cost
78.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012641NYMDClinical Psychologist
6027GAMDMedical Physician Assistant
23012641NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse Physician Assistant CurrentSince Jul 17, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 4, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 4, 2022 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Jul 17, 2025 Accepting new patients
Upstate Neurosurgery LLP CurrentSince Aug 24, 2017 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

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

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

750 E Adams St
Ste 2104
Syracuse, NY 13210
Phone (315) 464-2300

4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470

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

Interoperability endpoints

  • Direct secure messaging: sstuck71155@direct.upstate.edu

Organizations & group practices 6

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1235394388",
    "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": "315-464-8035",
            "fax_number": "315-464-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "SUSAN",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6027",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "23012641",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012641",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.