NPIMap

Individual provider Active NPI

Kate Elizabeth Symenow, RPA C

  • Physician Assistant
  • Watertown, NY
National Provider Identifier
1245217280
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0100191
Practice address
19436 Howell Dr
Suite a
Watertown, NY 13601-6459
Phone
(315) 786-2000
Fax
(315) 786-2899
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 0100191 Primary

Addresses

Primary practice location

19436 Howell Dr
Suite a
Watertown, NY 13601-6459

Mailing address

19436 Howell Dr
Suite a
Watertown, NY 13601-6459
Phone (315) 786-2000

Other identifiers 1

IdentifierTypeStateIssuer
02698635MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000434 NY Practitioner - Physician Assistant 8123092350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Practice PCGroup PAC ID 5698853133, 29 clinicians

Practice addresses (Care Compare)

629 Washington St
Watertown, NY 13601-4836
Phone (315) 755-3650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward John Noble Hospital of Gouverneur Ny Swing Bed Unit Past Accepting new patients
Edward John Noble Hospital of Gouverneur Ny Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ksymenow@samaritanmedicalpractice.medentdirect.com

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 8

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1245217280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19436 HOWELL DR",
            "address_2": "SUITE A",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136016459",
            "telephone_number": "315-786-2000",
            "fax_number": "315-786-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19436 HOWELL DR",
            "address_2": "SUITE A",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136016459",
            "telephone_number": "315-786-2000",
            "fax_number": "315-786-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMENOW",
        "first_name": "KATE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RPA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "0100191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02698635",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.