NPIMap

Organization Active NPI

Associated Medical Professionals of Ny, PLLC

  • Urology Physician
  • Syracuse, NY
National Provider Identifier
1467659060
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Practice address
1226 E Water St
Syracuse, NY 13210-1155
Phone
(315) 478-2887
Fax
(315) 478-0840
NPI assigned
Jun 28, 2007
Last updated
Aug 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Dr. Angelo R Derosalia, MDNPI 1649444183
Title
Ceo
Phone
(315) 458-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU
Vascular & Interventional Radiology Physician 2085R0204X NU
Urology Physician 208800000X NU 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) 870-9370

Other practice location 1

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

Other practice location 2

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

Other practice location 3

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

Other practice location 4

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

Other practice location 5

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

Other practice location 6

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

Other practice location 7

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

Other identifiers 1

IdentifierTypeStateIssuer
02922109MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071119000351 NY Part B Supplier - Clinic/Group Practice 0749378123 Receives reassigned benefits from 64 practitioners
Practice locations: Utica, NY; Syracuse, NY; Camillus, NY; Oneida, NY; New Hartford, NY; Liverpool, NY; Fayetteville, NY; Canton, NY…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0979951Associated Medical Professionals of Ny80 E Main Street, Canton, NY 13617Certificate of waiverNov 5, 2026

National Provider Directory

National Provider Directory

Locations

80 E Main St
Ste 2A
Canton, NY 13617
Phone 3157142559 ext. 42559

4000 Medical Center Dr
Ste 211
Fayetteville, NY 13066

Ownership & related parties

Subparts reporting this organization as parent 14

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 14

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1467659060",
    "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": "315-870-9370",
            "fax_number": "315-558-6611"
        },
        {
            "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": "315-478-2887",
            "fax_number": "315-478-0840"
        }
    ],
    "practiceLocations": [
        {
            "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": "2 Ellinwood Dr",
            "address_purpose": "LOCATION",
            "city": "New Hartford",
            "state": "NY",
            "postal_code": "134131102",
            "country_code": "US",
            "telephone_number": "315-724-1012",
            "fax_number": "315-721-5219",
            "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"
        },
        {
            "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": "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": "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": "5100 W Taft Rd Ste 4D",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883810",
            "country_code": "US",
            "telephone_number": "315-458-6669",
            "fax_number": "315-458-0819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "DEROSALIA",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-458-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02922109",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.