Individual provider Active NPI

Cassidy Callahan

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1295125581
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018378-1 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-5540
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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 018378-1 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

2136 Singing Woods Dr
Skaneateles, NY 13152-8932
Phone (315) 857-3334

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
I20150325000932 NY Practitioner - Physician Assistant 1557688801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018378NYMDSpeech-Language Pathologist
018378-1NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ccallahan43871@direct.upstate.edu

Organizations & group practices 2

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 1

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": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1295125581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 SINGING WOODS DR",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131528932",
            "telephone_number": "315-857-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "CASSIDY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018378-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.