Individual provider Active NPI

Kara Timmins, PA

  • Surgical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1437368701
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
011718 Issued in NY
Practice address
301 Prospect Ave
Clinical Affiliates
Syracuse, NY 13203-1807
Phone
(315) 448-5111
Fax
(315) 703-5049
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 011718 NY Primary
Medical Physician Assistant 363AM0700X 011718 NY

Addresses

Primary practice location

301 Prospect Ave
Clinical Affiliates
Syracuse, NY 13203-1807

Mailing address

104 Union Ave
Suite 804
Syracuse, NY 13203-1843
Phone (315) 703-5049

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090710000001 NY Practitioner - Physician Assistant 8022160720 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011718NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical Associates, LLP Past Accepting new patients
Cornell University Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1437368701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 UNION AVE",
            "address_2": "SUITE 804",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031843",
            "telephone_number": "315-703-5049",
            "fax_number": "315-703-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "CLINICAL AFFILIATES",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111",
            "fax_number": "315-703-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMINS",
        "first_name": "KARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011718",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.