Individual provider Active NPI

Kyle Michael Alpha, MD, PHD

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1265137236
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
332023 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1899
Phone
(315) 448-5111
Fax
(315) 448-6313
NPI assigned
Mar 31, 2023
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 332023 NY Primary
Obstetrics Physician 207VX0000X 332023 NY

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1899

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1899
Phone (315) 448-5111

Other practice location 1

5301 W Genesee St
Camillus, NY 13031-2238
Phone (315) 833-9900

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612001452 NY Practitioner - Family Practice 5597237313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807

301 Prospect Ave
Syracuse, NY 13203-1898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
332023NYMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC Family Medicine PastSince Sep 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kalpha@hiemail.healtheconnections.org
  • Direct secure messaging: kalpha2736363@direct.trinity-health.org

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1265137236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031899",
            "telephone_number": "315-448-5111",
            "fax_number": "857-270-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031899",
            "telephone_number": "315-448-5111",
            "fax_number": "315-448-6313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 W Genesee St",
            "address_purpose": "LOCATION",
            "city": "Camillus",
            "state": "NY",
            "postal_code": "130312238",
            "country_code": "US",
            "telephone_number": "315-833-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALPHA",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "332023",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "332023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.