Individual provider Active NPI

Tracy Oneill, PA

  • Medical Physician Assistant
  • North Syracuse, NY
National Provider Identifier
1487756136
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
009059 Issued in NY
Practice address
1304 Buckley Rd
North Syracuse, NY 13212-4311
Phone
(315) 478-3311
Fax
(315) 476-5211
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 009059 NY Primary

Addresses

Primary practice location

1304 Buckley Rd
North Syracuse, NY 13212-4311

Mailing address

1304 Buckley Rd
North Syracuse, NY 13212-4311
Phone (315) 478-3311

Other identifiers 1

IdentifierTypeStateIssuer
02366576MedicaidNY

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
I20040105000347 NY Practitioner - Physician Assistant 3375442809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Syracuse, P.C.Group PAC ID 2769379015, 13 clinicians

Practice addresses (Care Compare)

1304 Buckley Rd
Syracuse, NY 13212-4311

1304 Buckley Rd
Suite 200
Syracuse, NY 13212-4317
Phone (315) 478-3311

Hospital & facility affiliations

  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009059NYMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tpaddock@hiemail.healtheconnections.org

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 2

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1487756136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-478-3311",
            "fax_number": "315-476-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-478-3311",
            "fax_number": "315-476-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEILL",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02366576",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.