Individual provider Active NPI

Agata Wojtasiewicz, MD.

  • Family Medicine Physician
  • Baldwinsville, NY
National Provider Identifier
1376798520
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
259755 Issued in NY
Practice address
8278 Willett Parkway
2ND Floor
Baldwinsville, NY 13027
Phone
(315) 652-1325
Fax
(315) 857-2886
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 259755 NY Primary

Addresses

Primary practice location

8278 Willett Parkway
2ND Floor
Baldwinsville, NY 13027

Mailing address

5112 West Taft Road
Suite L
Liverpool, NY 13088
Phone (315) 452-2500

Other identifiers 1

IdentifierTypeStateIssuer
03308270MedicaidNY

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
I20110311000463 NY Practitioner - Family Practice 0042492001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

5100 W Taft Rd
Liverpool, NY 13088-3807
Phone (315) 452-2828

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
  • Nascentia Health at Home Home health agency, Syracuse, NY, CCN 337052
  • Hospice of Central New York Hospice, Liverpool, NY, CCN 331511
  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
259755NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Family Medicine Current Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
St Joseph'S Hospital Health Center Family Medicine CurrentSince Apr 11, 2011 Accepting new patients
St Josephs Hospital Health Center CurrentSince Apr 11, 2011 Accepting new patients

Locations

8278 Willett Pkwy
Fl 2
Baldwinsville, NY 13027
Phone (315) 652-1325

4104 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7001

5100 W Taft Rd
Ste 1D
Liverpool, NY 13088
Phone (315) 452-2828

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

5112 W Taft Rd
Ste L
Liverpool, NY 13088

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

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

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

Interoperability endpoints

  • Direct secure messaging: awojtasiewicz2386664@direct.trinity-health.org

Organizations & group practices 4

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1376798520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT ROAD",
            "address_2": "SUITE L",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2500",
            "fax_number": "315-452-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8278 WILLETT PARKWAY",
            "address_2": "2ND FLOOR",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027",
            "telephone_number": "315-652-1325",
            "fax_number": "315-857-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJTASIEWICZ",
        "first_name": "AGATA",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "259755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03308270",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinsville, NY

Sources for this page

Verify at the official NPI Registry.