Individual provider Active NPI

Brandon Truong

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1275137499
Registry record updated Nov 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
320 Montgomery St Apt 23
Syracuse, NY 13202-2531
Phone
(315) 373-6463
NPI assigned
Nov 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 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

320 Montgomery St Apt 23
Syracuse, NY 13202-2531

Mailing address

320 Montgomery St Apt 23
Syracuse, NY 13202-2531
Phone (315) 373-6463

Other names 1

  • Brandon Truong Professional name

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
I20210122000548 NY Practitioner - Physician Assistant 5294149829 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital Inc CurrentSince Jan 15, 2024 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Jan 15, 2024 Accepting new patients

Locations

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 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1275137499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MONTGOMERY ST APT 23",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022531",
            "telephone_number": "315-373-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MONTGOMERY ST APT 23",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022531",
            "telephone_number": "315-373-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "TRUONG",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.