Individual provider Active NPI

Emma Rudnick, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1245056142
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032661 Issued in NY
Practice address
725 E Adams St
Syracuse, NY 13210-2576
Phone
(315) 464-5726
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 032661 NY Primary

Addresses

Primary practice location

725 E Adams St
Syracuse, NY 13210-2576

Mailing address

6 E Lake St
Skaneateles, NY 13152-1305
Phone (315) 515-8089

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
I20250225003250 NY Practitioner - Physician Assistant 3173043882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Suny Health Science Center at SyracuseGroup PAC ID 7214833086, 210 clinicians

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

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032661NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Feb 13, 2025 Accepting new patients
Suny Health Science Center at Syracuse Physician Assistant CurrentSince Feb 13, 2025 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

725 E Adams St
Syracuse, NY 13210
Phone (315) 464-4357

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

Interoperability endpoints

  • Direct secure messaging: erudnick145547@direct.upstate.edu

Organizations & group practices 3

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1245056142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E LAKE ST",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521305",
            "telephone_number": "315-515-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102576",
            "telephone_number": "315-464-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICK",
        "first_name": "EMMA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.