Individual provider Active NPI

Alicia Detraglia, MD

  • Hematology & Oncology Physician
  • Utica, NY
National Provider Identifier
1376532499
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
228220-1 Issued in NY
Practice address
807 Newell St
Utica, NY 13502-5313
Phone
(315) 798-9300
Fax
(315) 793-8320
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 228220-1 NY Primary

Addresses

Primary practice location

807 Newell St
Utica, NY 13502-5313

Mailing address

807 Newell St
Utica, NY 13502-5313
Phone (315) 798-9300

Other identifiers 1

IdentifierTypeStateIssuer
02428600MedicaidNY

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
I20071101000534 NY Practitioner - Hematology/Oncology 8921195348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Albany Medical College of Union University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

  • Hospice and Palliative Care Inc New Hartford Hospice, New Hartford, NY, CCN 331510
  • Wynn Hospital Hospital, Utica, NY, CCN 330044
  • Lewis County General Hospital Hospital, Lowville, NY, CCN 331317

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228220-1NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Jan 1, 2018 Accepting new patients
MVHS Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

4401 Middle Settlement Rd
New Hartford, NY 13413
Phone (315) 734-3471

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

120 Hobart St
Utica, NY 13501
Phone (315) 798-1149

Interoperability endpoints

  • Direct secure messaging: adetraglia11972@mvhealthsystem.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
MVHS IncUtica, NY, CCN 33T044 Hospital Corporate Director Jan 1, 2018
Visiting Nurse Association of Utica and Oneida County IncUtica, NY, CCN 337078 Home health agency Corporate Director Jan 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1376532499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 NEWELL ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025313",
            "telephone_number": "315-798-9300",
            "fax_number": "315-793-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 NEWELL ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025313",
            "telephone_number": "315-798-9300",
            "fax_number": "315-793-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRAGLIA",
        "first_name": "ALICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "228220-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02428600",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.