North Shore Medical Group PLLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

NORTH SHORE MEDICAL GROUP PLLC

Practice address

311 Skyview Ter
Syracuse, NY 13219-2835

Phone

(315) 935-1154

Fax

(952) 209-2012

NPI assigned

Oct 12, 2020

Organization subpart

No

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

Authorized official

Name

Joshu Coppola, PA

Title

PA

Phone

(315) 289-6300

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen M Wolff, AUD.

  • Audiologist
  • Lake Placid, NY
  • NPI 1972720720
  NPD (past)

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1487252581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SKYVIEW TER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192835",
            "telephone_number": "315-935-1154",
            "fax_number": "952-209-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SKYVIEW TER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192835",
            "telephone_number": "315-935-1154",
            "fax_number": "952-209-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "JOSHU",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "315-289-6300",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Kathleen Norris, PA
• Casey Norris
• Donna Norris, R.N.
• Jenna Norris
• Jilliann Norris
• Northern Orthopedic Laboratory, Inc.
• Hannah Elizabeth Northrop, M.S.
• Susan Hyde Northrop, M.S.
• Northstar Supply Corporation
• Christine Anne Norton, NURSE PRACTITIONER

• Adult Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Adult Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.