Individual provider Active NPI

Cooper Michael White

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1629664842
Registry record updated Dec 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026079 Issued in NY
Practice address
6227 Thompson Rd
Syracuse, NY 13206-1405
Phone
(315) 937-2007
NPI assigned
Dec 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 026079 NY Primary

Addresses

Primary practice location

6227 Thompson Rd
Syracuse, NY 13206-1405

Mailing address

7 Quaker Hill Rd
Syracuse, NY 13224-2011

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
I20210122002467 NY Practitioner - Physician Assistant 2365856937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1600 Erie Blvd E
Syracuse, NY 13210-1212
Phone (315) 401-3204

3800 W Genesee St
Syracuse, NY 13219-1928
Phone (315) 552-9080

3840 State Route 31
Liverpool, NY 13090-1310
Phone (315) 715-6319

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

4995 Wintersweet Dr
Liverpool, NY 13088-2176
Phone (315) 401-3210

514 S 2ND St
Fulton, NY 13069-2804
Phone (315) 552-9104

6227 Thompson Rd
Syracuse, NY 13206-1405
Phone (315) 937-2007

6870 E Genesee St
Fayetteville, NY 13066-1031
Phone (315) 679-4367

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1629664842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 QUAKER HILL RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132242011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6227 THOMPSON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132061405",
            "telephone_number": "315-937-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "COOPER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-13",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.