Individual provider Active NPI

Patrice Renee Paolucci, D.O.

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1316180573
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
267970 Issued in NY
Practice address
770 James St
Ste 100
Syracuse, NY 13203-2117
Phone
(315) 422-2222
Fax
(315) 472-8497
NPI assigned
Apr 16, 2009
Last updated
Oct 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 267970 NY Primary

Addresses

Primary practice location

770 James St
Ste 100
Syracuse, NY 13203-2117

Mailing address

792 N Main St
Ste 100a
North Syracuse, NY 13212-1644
Phone (315) 423-9722

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
I20130821000202 NY Practitioner - Obstetrics/Gynecology 8426291535 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates for Women's Medicine PLLCGroup PAC ID 4880677400, 17 clinicians

Practice addresses (Care Compare)

792 /2 N Main St
North Syracuse, NY 13212-1670
Phone (315) 701-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center CurrentSince May 1, 2020 Accepting new patients
OBGYN Hospitalist Medical Services of New York, P.C. Obstetrics & Gynecology CurrentSince Jun 4, 2021 Accepting new patients
St Josephs Medical PC CurrentSince May 1, 2020 Accepting new patients
North Medical PC Obstetrics & Gynecology Current Accepting new patients
Eastern Niagara Radiology & Nuclear Medicine Associates, PC Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

2210 Troy Schenectady Rd
Schenectady, NY 12309
Phone (518) 346-6400

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

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

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

Organizations & group practices 6

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1316180573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "STE 100A",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-423-9722",
            "fax_number": "315-423-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 JAMES ST",
            "address_2": "STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032117",
            "telephone_number": "315-422-2222",
            "fax_number": "315-472-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLUCCI",
        "first_name": "PATRICE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "267970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.