Sandra E Gibson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016973 Issued in NY

Practice address

5496 E Taft Rd
North Syracuse, NY 13212-3784

Phone

(315) 552-6700

Fax

(315) 552-6701

NPI assigned

Sep 16, 2013

Last updated

Aug 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sandra E. Sekuterski Former name

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina-Vitreous Surgeons of Central New York PCGroup PAC ID 4385622927, 6 clinicians

Neurology Medical Service Group LLPGroup PAC ID 7214928035, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score

94.06 of 100Reported as group

Quality

92.53

Promoting interoperability

100

Improvement activities

40

Cost

66.03

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgibson55344@direct.upstate.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Retina-Vitreous Surgeons of Central New York, PC

  • Retina Specialist (Ophthalmology) Physician
  • Liverpool, NY
  • NPI 1124012737
  Medicare reassignment Care Compare group NPD
• Neurology Medical Service Group, LLP

  • Neurology Physician
  • Syracuse, NY
  • NPI 1518907096
  Medicare reassignment Care Compare group
• New York Anesthesiology Medical Specialties, PC

  dba New York Spine and Wellness Center

  • Durable Medical Equipment & Medical Supplies
  • Camillus, NY
  • NPI 1023497203
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1447686050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-552-6700",
            "fax_number": "315-552-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-552-6700",
            "fax_number": "315-552-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SANDRA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03804024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "SEKUTERSKI",
            "middle_name": "E.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Sarah Ellen Gerace, MA, LP-MFT
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• Hope Brown Goettel, MSED
• Summer Ann Goetz, FNP

• 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 Aug 11, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.