Individual provider Active NPI

Amanda Chase Grossi

  • Student in an Organized Health Care Education/Training Program
  • Syracuse, NY
National Provider Identifier
1639800246
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1419 Salt Springs Rd
Syracuse, NY 13214
Phone
(315) 445-4100
NPI assigned
Jun 23, 2022
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

1419 Salt Springs Rd
Syracuse, NY 13214

Mailing address

1419 Salt Springs Rd
Syracuse, NY 13214-1302
Phone (315) 445-4100

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
I20240116001314 NY Practitioner - Physician Assistant 2365894391 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030751NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks - TLC Hospital System, Inc. CurrentSince Sep 2, 2025 Accepting new patients
Brooks-TLC Hospital System, Inc. CurrentSince Sep 2, 2025 Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

34 Commercial St
Gowanda, NY 14070
Phone (716) 532-3377

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1639800246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SALT SPRINGS RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141302",
            "telephone_number": "315-445-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 SALT SPRINGS RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13214",
            "telephone_number": "315-445-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSI",
        "first_name": "AMANDA",
        "middle_name": "CHASE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.