Individual provider Active NPI

Angela Patricia Mojica Sanabria, MD

  • Pediatric Endocrinology Physician
  • Syracuse, NY
National Provider Identifier
1487949913
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
284885 Issued in NY
Practice address
3229 East Genesee St Ste 1
Syracuse, NY 13214
Phone
(315) 464-5726
Fax
(315) 464-2510
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X TRN12926 FL
Pediatric Endocrinology Physician 2080P0205X 284885 NY Primary

Addresses

Primary practice location

3229 East Genesee St Ste 1
Syracuse, NY 13214

Mailing address

725 East Adams St
5TH FL
Syracuse, NY 13210
Phone (315) 464-5726

Other identifiers 1

IdentifierTypeStateIssuer
04492646MedicaidNY

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
I20160907001391 NY Practitioner - EndocrinologyPractitioner - Pediatric Medicine 4981829645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Service GroupGroup PAC ID 9931007200, 12 clinicians

Practice addresses (Care Compare)

725 E Adams St FL 5 Bandc
Pediatric Diabetes Endocrine and Metabolism
Syracuse, NY 13210-2306
Phone (315) 464-5726

750 E Adams St
Syracuse, NY 13210-2306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN12926FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Service Group Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Past Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

3229 E Genesee St
Ste 1
Syracuse, NY 13214
Phone (315) 464-5726

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

725 E Adams St
Fl 5
Syracuse, NY 13210
Phone (315) 464-5726

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: amojicasanabria59288@direct.upstate.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1487949913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 EAST ADAMS ST",
            "address_2": "5TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 EAST GENESEE ST STE 1",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13214",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA SANABRIA",
        "first_name": "ANGELA",
        "middle_name": "PATRICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "TRN12926",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "284885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04492646",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.