Individual provider Active NPI

Reggie Testa Cayetano, PA

  • Medical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1629523956
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Phone
(315) 701-2550
Fax
(315) 701-2551
NPI assigned
Aug 16, 2016
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 20221 NY
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

739 Irving Ave Ste 600
Syracuse, NY 13210-1663

Mailing address

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

Other practice location 1

601 Elmwood Ave Box 619-13
Rochester, NY 14642-0001
Phone (585) 275-6366

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rcayetano@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC
Direct Messaging Address rcayetano109640@direct.urmc.rochester.edu Direct
Direct Messaging Address rcayetano109640@direct.urmc.rochester.edu Direct

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
I20161116002480 NY Practitioner - Physician Assistant 7214216183 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine GroupGroup PAC ID 3476454661, 166 clinicians
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-7424

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20221NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice PLLC CurrentSince May 1, 2021 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#61913
Rochester, NY 14642
Phone (585) 275-6366

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

739 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 471-0190

Interoperability endpoints

  • Direct secure messaging: rcayetano@crousemed.medentdirect.com
  • Direct secure messaging: rcayetano109640@direct.urmc.rochester.edu

Organizations & group practices 8

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 3

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1629523956",
    "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 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101663",
            "telephone_number": "315-701-2550",
            "fax_number": "315-701-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave Box 619-13",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-6366",
            "fax_number": "585-276-1974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAYETANO",
        "first_name": "REGGIE",
        "middle_name": "TESTA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-16",
        "last_updated": "2023-06-29",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "20221",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcayetano@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Syracuse",
            "address_1": "739 Irving Ave Ste 600",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcayetano109640@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcayetano109640@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.