Individual provider Active NPI

Dawn C Richardson, MD

  • Family Medicine Physician
  • Fayetteville, NY
National Provider Identifier
1689012650
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
220282-1 Issued in NY
Practice address
4101 Medical Center Dr
Fayetteville, NY 13066-6600
Phone
(315) 637-7878
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 220282-1 NY Primary

Addresses

Primary practice location

4101 Medical Center Dr
Fayetteville, NY 13066-6600

Mailing address

4101 Medical Center Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

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
I20130925000896 NY Practitioner - Family Practice 8527054485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York Downstate Medical Center, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

4101 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

4103 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1500

4104 Medical Ctr Dr
Suite 104
Fayetteville, NY 13066-6635
Phone (315) 663-0059

4117 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1551

5100 W Taft Rd
Liverpool, NY 13088-3807
Phone (315) 452-2828

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220282-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Family Medicine Current Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Jul 15, 2013 Accepting new patients
Nephrology Associates of Syracuse, P.C. Past Accepting new patients

Locations

4101 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 637-7878

4000 Medical Center Dr
Ste 101C
Fayetteville, NY 13066

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Rm 1605
Syracuse, NY 13203

Interoperability endpoints

  • Direct secure messaging: drichardson2387655@direct.trinity-health.org

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.

Hospital & facility affiliations 5

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1689012650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DAWN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "220282-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.