Individual provider Active NPI

Timothy Richardson, PA.

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1407378136
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
036109 Issued in NY
Practice address
1226 E Water St
Syracuse, NY 13210-1155
Phone
(315) 478-4185
Fax
(315) 478-0840
NPI assigned
Jul 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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 036109 NY Primary

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

357 Genesee St Ste 1
Oneida, NY 13421-2658
Phone (315) 363-8862

Other practice location 2

2 Ellinwood Dr
New Hartford, NY 13413-1102
Phone (315) 724-1012

Other practice location 3

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

Other practice location 4

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

Other practice location 5

4211 Medical Center Dr Ste 211
Fayetteville, NY 13066-6637
Phone (315) 329-0210

Other practice location 6

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

Other practice location 7

80 E Main St Ste 2A
Canton, NY 13617-1450
Phone (315) 714-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220002539 CO Practitioner - Physician Assistant 2466719943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology PLLCGroup PAC ID 2365346558, 58 clinicians

Practice addresses (Care Compare)

10535 Park Meadows Blvd
Suite 102
Lone Tree, CO 80124-8455
Phone (303) 695-6106

32135 Castle CT
Suite 101
Evergreen, CO 80439-8006
Phone (303) 985-2550

Hospital & facility affiliations

  • Sky Ridge Medical Center Hospital, Lone Tree, CO, CCN 060112
  • The Medical Center of Aurora & South Hospital Hospital, Aurora, CO, CCN 060100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60779457WAMDPhysician Assistant
PA0007294COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology, PLLC Current Accepting new patients
Foothills Urology, PC Current Accepting new patients
Advanced Urology, PLLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

2352 Meadows Blvd
Ste 300
Castle Rock, CO 80109
Phone (303) 744-1961

4350 Limelight Ave
Unit 250
Castle Rock, CO 80109
Phone (303) 697-1636

4500 E 9th Ave
Ste 470
Denver, CO 80220
Phone (303) 320-8499

1411 S Potomac St
Ste 210
Denver, CO 80012
Phone (303) 750-0883

32135 Castle Ct
Ste 101
Evergreen, CO 80439
Phone (303) 679-8500

10535 Park Meadows Blvd
Ste 102
Lone Tree, CO 80124
Phone (303) 695-1211

10535 Park Meadows Blvd
Ste 105
Lone Tree, CO 80124

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

Interoperability endpoints

  • Direct secure messaging: timothyrichardson@fu.allscriptsdirect.net
  • Direct secure messaging: timothy.richardson.1@13869.direct.athenahealth.com

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 12

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1407378136",
    "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": "315-870-9364"
        },
        {
            "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": "357 Genesee St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Oneida",
            "state": "NY",
            "postal_code": "134212658",
            "country_code": "US",
            "telephone_number": "315-363-8862",
            "fax_number": "315-363-3326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Ellinwood Dr",
            "address_purpose": "LOCATION",
            "city": "New Hartford",
            "state": "NY",
            "postal_code": "134131102",
            "country_code": "US",
            "telephone_number": "315-724-1012",
            "fax_number": "315-724-5219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "192 Genesee St",
            "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": "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"
        },
        {
            "address_1": "4211 Medical Center Dr Ste 211",
            "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": "5100 W Taft Rd Ste 4J",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883810",
            "country_code": "US",
            "telephone_number": "315-458-6669",
            "fax_number": "315-478-0840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 E Main St Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "136171450",
            "country_code": "US",
            "telephone_number": "315-714-2559",
            "fax_number": "315-386-3056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PA.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "036109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.