Individual provider Active NPI

Gerald Patrick Edwards, MD.

  • Family Medicine Physician
  • Cazenoviz, NY
National Provider Identifier
1487673125
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
191431 Issued in NY
Practice address
132 1/2 Albany Street
Cazenoviz, NY 13035
Phone
(315) 655-8171
Fax
(315) 655-5923
NPI assigned
Jul 19, 2006
Last updated
Jan 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 191431 NY Primary
Obstetrics & Gynecology Physician 207V00000X 191431 NY

Addresses

Primary practice location

132 1/2 Albany Street
Cazenoviz, NY 13035

Mailing address

5112 West Taft Road
Suite L
Liverpool, NY 13088
Phone (315) 452-2500

Other identifiers 1

IdentifierTypeStateIssuer
01546309MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108001167 NY Practitioner - Family Practice 3274596507 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians
St Josephs Hospital Health CenterGroup PAC ID 9234043324, 107 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

4101 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

4103 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1500

4117 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1551

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
191431NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Physician Health, P.C. Family Medicine CurrentSince Jan 1, 1997 Accepting new patients
St. Joseph's Pathology, PC Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Sep 1, 2005 Accepting new patients
Emergency Care Services of New York, P.C. CurrentSince Jan 1, 2007 Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
North Medical PC Family Medicine Current Accepting new patients
Emergency Medicine Physicians of Onondaga County, PLLC Past Accepting new patients

Locations

132 Albany St
Ste 12
Cazenovia, NY 13035
Phone (315) 655-3668

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

5112 W Taft Rd
Ste L
Liverpool, NY 13088

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

301 Prospect Ave
Rm 1605
Syracuse, NY 13203

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

Interoperability endpoints

  • Direct secure messaging: gedwards2389975@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1487673125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT ROAD",
            "address_2": "SUITE L",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2500",
            "fax_number": "315-452-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 1/2 ALBANY STREET",
            "city": "CAZENOVIZ",
            "state": "NY",
            "postal_code": "13035",
            "telephone_number": "315-655-8171",
            "fax_number": "315-655-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "GERALD",
        "middle_name": "PATRICK",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "191431",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "191431",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01546309",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenoviz, NY

Sources for this page

Verify at the official NPI Registry.