Individual provider Active NPI

Efrain A Agama, M.A.

  • Marriage & Family Therapist
  • Syracuse, NY
National Provider Identifier
1750582771
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
324 University Ave
Syracuse, NY 13210-1811
Phone
(315) 472-4471
Fax
(315) 472-1759
NPI assigned
May 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

324 University Ave
Syracuse, NY 13210-1811

Mailing address

402 Ansonia CT
Camillus, NY 13031-3002
Phone (315) 729-3245

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212000159 NY Practitioner - Marriage and Family Therapist 6901249580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

1045 James St
Syracuse, NY 13203-2730
Phone 31547244711384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000858NYMDPsychoanalyst

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources Inc. CurrentSince Jan 1, 2024 Accepting new patients
Liberty Resources, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1045 James St
Syracuse, NY 13203
Phone (315) 413-7692

324 University Ave
Syracuse, NY 13210
Phone (315) 472-4771

Interoperability endpoints

  • Direct secure messaging: efrain.agama.p1@direct.liberty-resources.nextgenshare.com

Organizations & group practices 2

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750582771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ANSONIA CT",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313002",
            "telephone_number": "315-729-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 UNIVERSITY AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101811",
            "telephone_number": "315-472-4471",
            "fax_number": "315-472-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAMA",
        "first_name": "EFRAIN",
        "middle_name": "A",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.