Individual provider Active NPI

Merrick Lynne Doody, PA

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1316452964
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021691-1 Issued in NY
Practice address
104 Union Ave # 806-807
Syracuse, NY 13203-1843
Phone
(315) 474-0542
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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 021691-1 NY Primary

Addresses

Primary practice location

104 Union Ave # 806-807
Syracuse, NY 13203-1843

Mailing address

322 Miles Ave
Syracuse, NY 13210-3120

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
I20180125003262 NY Practitioner - Physician Assistant 1658630322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1600 Erie Blvd E
Syracuse, NY 13210-1212
Phone (315) 401-3204

3800 W Genesee St
Syracuse, NY 13219-1928
Phone (315) 552-9080

3840 State Route 31
Liverpool, NY 13090-1310
Phone (315) 715-6319

6227 Thompson Rd
Syracuse, NY 13206-1405
Phone (315) 937-2007

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021691NYMDSpeech-Language Pathologist
021691-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients

Locations

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

Organizations & group practices 3

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": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1316452964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MILES AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 UNION AVE # 806-807",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031843",
            "telephone_number": "315-474-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOODY",
        "first_name": "MERRICK",
        "middle_name": "LYNNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021691-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.