Individual provider Active NPI

Meghan Maynard

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1487282943
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
739 Irving Ave Ste 500
Syracuse, NY 13210-1664
Phone
(315) 470-7409
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

739 Irving Ave Ste 500
Syracuse, NY 13210-1664

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

Other practice location 1

231 Clayton Manor Dr S Apt 5
Liverpool, NY 13088-5671
Phone (315) 481-6985

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmaynard@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

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
I20210317000914 NY Practitioner - Physician Assistant 9436565488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

5000 Brittonfield Pkwy
Suite A125
East Syracuse, NY 13057-9230
Phone (315) 802-2601

5417 W Genesee St
Camillus, NY 13031-2176
Phone (315) 476-2323

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-7111

739 Irving Ave
Syracuse, NY 13210-1651

739 Irving Ave
Suite 500
Syracuse, NY 13210-1664
Phone (315) 470-7409

8324 Oswego Rd
Liverpool, NY 13090-1086

Hospital & facility affiliations

  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice, PLLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

5000 Brittonfield Pkwy
Ste B101
East Syracuse, NY 13057
Phone (315) 470-7409

8324 Oswego Rd
Ste C
Liverpool, NY 13090
Phone (315) 470-7409

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

739 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 453-4262

739 Irving Ave
Ste 550
Syracuse, NY 13210
Phone (315) 766-1666

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Interoperability endpoints

  • Direct secure messaging: mmaynard@crousemed.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1487282943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101664",
            "telephone_number": "315-470-7409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Clayton Manor Dr S Apt 5",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130885671",
            "country_code": "US",
            "telephone_number": "315-481-6985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MEGHAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaynard@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 500",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.