Joshua Daniel Justin, PA-C
Individual provider Active NPI Medical Physician Assistant · Skaneateles, NY
NPI 1679909790 · NPPES record last updated Sep 20, 2013
Key facts
- NPI
- 1679909790
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 23017040 (NY)
- Practice address
- 791 W Genesee Street Rd
Skaneateles, NY 13152-9377 - Phone
- (315) 685-7544
- NPI assigned
- Sep 20, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crouse Health Hospital Inc
Practice addresses (Care Compare)
736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111
Hospital & facility affiliations
- Crouse Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140127001347 | NY | Practitioner - Physician Assistant | 6800025636 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23017040 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Associates of Syracuse, PC | Current | Accepting new patients | |
| Crouse Health Hospital Inc | Current |
Accepting new patients | |
| Crouse Health Hospital, Inc. | Current |
Accepting new patients | |
| Crouse Health Inc. | Past | Accepting new patients |
Locations
1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488
736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 23017040 | NY | Yes |
Addresses
Primary practice location
791 W Genesee Street Rd
Skaneateles, NY 13152-9377
Mailing address
791 W Genesee Street Rd
Skaneateles, NY 13152-9377
Phone (315) 685-7544
Other providers in Skaneateles, NY
- Jaebsary Patient Transport, Inc.
- Kirby Janke
- Joshua Ray Jimenez
- John J Maurillo Odpc
- Joseph F. McCaffrey, M.D. PC
- Melissa Mary Kallfelz
- Gail B Keenen
- Kelly Springer Dietitian Nutritionist PLLC
- Kelly'S Choice, LLC
- Kelly'S Choice, LLC
All providers in Skaneateles, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.