Individual provider Active NPI

Andrew J Stephenson, MD

  • Urology Physician
  • Syracuse, NY
National Provider Identifier
1366478455
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036-148679 Issued in IL
Practice address
1226 E Water St
Syracuse, NY 13210-1155
Phone
(315) 478-4185
Fax
(315) 478-0840
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301117114 MI
Urology Physician 208800000X MD-46076 IA
Urology Physician 208800000X 01091812B IN
Urology Physician 208800000X 036-148679 IL Primary
Urology Physician 208800000X 35086609 OH

Addresses

Primary practice location

1226 E Water St
Syracuse, NY 13210-1155

Mailing address

100 Metropolitan Park Dr Ste 100
Liverpool, NY 13088-7112
Phone (315) 870-9369

Other practice location 1

1725 W Harrison St Ste 970
Chicago, IL 60612-3828
Phone (312) 563-3447

Other practice location 2

4211 Medical Center Dr
Fayetteville, NY 13066-6637
Phone (315) 329-0210

Other practice location 3

192 Genesee St Ste 100
Auburn, NY 13021-3361
Phone (315) 258-5253

Other practice location 4

806 W Broadway
Fulton, NY 13069-1571
Phone (315) 870-9369

Other practice location 5

5100 W Taft Rd Ste 4D
Liverpool, NY 13088-3810
Phone (315) 458-6669

Other practice location 6

5700 W Genesee St Ste 124
Camillus, NY 13031-3206
Phone (315) 478-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190531001212 IL Practitioner - Urology 3375563091 Reassigns benefits to 1 organization
I20231107001065 NY Practitioner - Urology 3375563091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Univ of Western Ontario Schulich School of Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Medical Professionals of Ny PLLCGroup PAC ID 0749378123, 57 clinicians

Practice addresses (Care Compare)

1226 E Water St
Syracuse, NY 13210-1155
Phone (315) 478-4185

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
  • Lewis County General Hospital Hospital, Lowville, NY, CCN 331317
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-46076IAMDUrology Physician
036-148679ILMDUrology Physician
01091812BINMDUrology Physician
4301117114MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Dec 1, 2023 Accepting new patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Dec 1, 2023 Accepting new patients
Rush University Medical Group Urology CurrentSince Jan 27, 2020 Accepting new patients
Crouse Radiology Associates LLP Past Accepting new patients
St Josephs Hospital Health Center Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

5700 W Genesee St
Ste 124
Camillus, NY 13031
Phone (315) 472-8841

806 W Broadway
Fulton, NY 13069
Phone (315) 255-1743

100 Metropolitan Park Dr
Ste 100
Liverpool, NY 13088
Phone (315) 870-9370

5100 W Taft Rd
Ste 4J
Liverpool, NY 13088
Phone (315) 701-2170

5100 W Taft Rd
Ste 4D
Liverpool, NY 13088
Phone (315) 452-2321

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

Interoperability endpoints

  • Direct secure messaging: astephenson149461@direct.rush.rush-health.com
  • Direct secure messaging: astephenson@ampofny.medentdirect.com

Organizations & group practices 7

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 6

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1366478455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR STE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130887112",
            "telephone_number": "315-870-9369",
            "fax_number": "312-563-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Harrison St Ste 970",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123828",
            "country_code": "US",
            "telephone_number": "312-563-3447",
            "fax_number": "312-563-3721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4211 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NY",
            "postal_code": "130666637",
            "country_code": "US",
            "telephone_number": "315-329-0210",
            "fax_number": "315-329-0215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "192 Genesee St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NY",
            "postal_code": "130213361",
            "country_code": "US",
            "telephone_number": "315-258-5253",
            "fax_number": "315-258-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "NY",
            "postal_code": "130691571",
            "country_code": "US",
            "telephone_number": "315-870-9369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5100 W Taft Rd Ste 4D",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883810",
            "country_code": "US",
            "telephone_number": "315-458-6669",
            "fax_number": "315-458-0819",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 W Genesee St Ste 124",
            "address_purpose": "LOCATION",
            "city": "Camillus",
            "state": "NY",
            "postal_code": "130313206",
            "country_code": "US",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301117114",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IA",
            "license": "MD-46076",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01091812B",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036-148679",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35086609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.