Individual provider Active NPI

Amanda Lynn Webb

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1265060016
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
736 Irving Ave
Syracuse, NY 13210-1690
Phone
(315) 651-8067
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1690

Mailing address

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 651-8067

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
I20201212000011 NY Practitioner - Physician Assistant 3173935392 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Community HospitalGroup PAC ID 2365346525, 61 clinicians
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7142

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

77 Nelson St
Auburn, NY 13021-1941

Hospital & facility affiliations

  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025826NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Memorial Medical Services, PC CurrentSince Nov 1, 2023 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Auburn Community Hospital CurrentSince Nov 1, 2023 Accepting new patients
Crouse Health Hospital Inc CurrentSince Oct 21, 2020 Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Oct 21, 2020 Accepting new patients
Auburn Community Hospital CurrentSince Nov 1, 2023 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 7

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 2

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1265060016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-651-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101690",
            "telephone_number": "315-651-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.