Dylan L Juda, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

026046 Issued in NY

Practice address

6846 Buckley Rd Ste 1
North Syracuse, NY 13212-4270

Phone

(315) 410-6400

Fax

(315) 410-6410

NPI assigned

Dec 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Nephrology Hypertension Associates of Cny,P.C.

  • Nephrology Physician
  • North Syracuse, NY
  • NPI 1760402564
  Medicare reassignment

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1407452709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6846 BUCKLEY RD STE 1",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124270",
            "telephone_number": "315-410-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6846 BUCKLEY RD STE 1",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124270",
            "telephone_number": "315-410-6400",
            "fax_number": "315-410-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDA",
        "first_name": "DYLAN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Jones
• Joseph G. Morra, O.D., P.C.
• Anita Joy, ANP
• Christine Maria Joy, OD
• Juan L. Sotomayor, M.D., P.C. (Allergy & Asthma Diagnostic Office)
• Brian Defreest Katt, LMT
• Suchitra Kavety, M.D.
• Deirdre Keenan, RPA-C
• Jason P Kelly, LMT
• Kristen Marie Kelsen, PHYSICAL THERAPIST

• Physician Assistant in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.