Active NPI
Joseph A Coffey, PA
- Physician Assistant
- Syracuse, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 016070
- Practice address
- 5719 Widewaters Pkwy
Syracuse, NY 13214-1985 - Phone
- (315) 251-3100
- Fax
- (315) 449-9923
- NPI assigned
- Nov 3, 2006
- Last updated
- Oct 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | P-T0616 | AR | |
| Physician Assistant | 363A00000X | 016070 | NY | Primary |
Addresses
Primary practice location
5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Mailing address
5824 Widewaters Pkwy
East Syracuse, NY 13057-3072
Phone (315) 251-3100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881663078 | Other | AR | NPI PROVIDER NUMBER PHY ASST LINK TO |
| DA7424 | Other | AR | PALMETTO MEDICARE RAILROAD |
| P-T0616 | Other | AR | LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Alabama School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111
415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310
5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016070 | NY | MD | Speech-Language Pathologist |
| P-T0616 | AR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Syracuse Orthopedic Specialists, PLLC | Current | Accepting new patients | |
| North Medical PC | Current | Accepting new patients | |
| Russell B Allison | Past | Accepting new patients | |
| Russell B Allison MD PA | Past | Accepting new patients |
Locations
5824 Widewaters Pkwy
East Syracuse, NY 13057
Phone (315) 251-3105
5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592
301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111
5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110
736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- Syracuse, NY
- NPI 1669410379
-
- Family Medicine Physician
- Liverpool, NY
- NPI 1942501747
-
- Family Medicine Physician
- Liverpool, NY
- NPI 1972563070
-
dba Central States Laboratory
- Clinical Medical Laboratory
- Pottsville, AR
- NPI 1134594229
-
dba Arkansas Orthopaedic Insitute
- Durable Medical Equipment & Medical Supplies
- Russellville, AR
- NPI 1871706127
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1508815333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1245319730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5824 WIDEWATERS PKWY",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130573072",
"telephone_number": "315-251-3100",
"fax_number": "315-449-9923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5719 WIDEWATERS PKWY",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132141985",
"telephone_number": "315-251-3100",
"fax_number": "315-449-9923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEY",
"first_name": "JOSEPH",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AR",
"license": "P-T0616",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "016070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI PROVIDER NUMBER PHY ASST LINK TO",
"identifier": "1881663078",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO MEDICARE RAILROAD",
"identifier": "DA7424",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "P-T0616",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.