NPIMap

Organization Active NPI

Associated Medical Professionals of Ny, PLLC

  • Urology Physician
  • Fulton, NY
National Provider Identifier
1386062990
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Practice address
806 W Broadway
Fulton, NY 13069-1533
Phone
(315) 297-4700
NPI assigned
Apr 1, 2014
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Dr. Angelo R. Derosalia, MDNPI 1649444183
Title
Authorized Official
Phone
(315) 458-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

806 W Broadway
Fulton, NY 13069-1533

Mailing address

100 Metropolitan Park Dr.
Suite 100
Liverpool, NY 13088-5842
Phone (315) 870-9370

National Provider Directory

National Provider Directory
Part of
Associated Medical Professionals of Ny PLLC

Locations

6 Euclid Ave
Ste 208
Cortland, NY 13045
Phone (607) 753-9076

4211 Medical Center Dr
#211
Fayetteville, NY 13066
Phone (315) 297-4700

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

4900 Broad Rd
Bldg N
Syracuse, NY 13215
Phone (315) 487-8109

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1386062990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR.",
            "address_2": "SUITE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885842",
            "telephone_number": "315-870-9370",
            "fax_number": "315-558-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W BROADWAY",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691533",
            "telephone_number": "315-297-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "enumeration_date": "2014-04-01",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "DEROSALIA",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "315-458-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.