Individual provider Active NPI

Cynthia J Young-Mayka, P.A.

  • Physician Assistant
  • Fulton, NY
National Provider Identifier
1396748448
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0040721 Issued in NY
Practice address
806 West Broadway Associated Medical Professionals
Fulton, NY 13069
Phone
(315) 297-4700
Fax
(315) 218-5898
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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 0040721 NY Primary

Addresses

Primary practice location

806 West Broadway Associated Medical Professionals
Fulton, NY 13069

Mailing address

100 Metropolitan Drive Associated Medical Professionals
Suite 200
Liverpool, NY 13088
Phone (315) 870-9370

Other identifiers 1

IdentifierTypeStateIssuer
01270915MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004072NYMDClinical Psychologist
0040721NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1396748448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN DRIVE ASSOCIATED MEDICAL PROFESSIONALS",
            "address_2": "SUITE 200",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-870-9370",
            "fax_number": "315-748-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 WEST BROADWAY ASSOCIATED MEDICAL PROFESSIONALS",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "13069",
            "telephone_number": "315-297-4700",
            "fax_number": "315-218-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-MAYKA",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0040721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01270915",
            "state": "NY"
        }
    ],
    "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 Jan 26, 2021; 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.