Individual provider Active NPI

Kimberly A Laxton, MD

  • Neurology Physician
  • Syracuse, NY
National Provider Identifier
1770015190
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
311745-01 Issued in NY
Practice address
90 Presidential Plaza
4TH Floor
Syracuse, NY 13202
Phone
(315) 464-4243
Fax
(315) 464-7328
NPI assigned
Apr 3, 2017
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 311745-01 NY Primary

Addresses

Primary practice location

90 Presidential Plaza
4TH Floor
Syracuse, NY 13202

Mailing address

90 Presidential PLZ Ste 100
Syracuse, NY 13202-2240
Phone (315) 464-4243

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
I20210902002240 NY Practitioner - Neurology 0648517250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of Ny Upstate Medical University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Medical Service Group LLPGroup PAC ID 7214928035, 39 clinicians

Practice addresses (Care Compare)

90 Presidential PLZ
Suite 4
Syracuse, NY 13202-2240
Phone (315) 464-4243

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.06 of 100Reported as group
Quality
92.53
Promoting interoperability
100
Improvement activities
40
Cost
66.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311745-01NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Medical Service Group, LLP Neurology CurrentSince Aug 1, 2021 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

90 Presidential Plz
#4
Syracuse, NY 13202
Phone (315) 464-4243

90 Presidential Plz
Fl 4
Syracuse, NY 13202
Phone (315) 464-4243

90 Presidential Plz
Ste 100
Syracuse, NY 13202

Interoperability endpoints

  • Direct secure messaging: klaxton54646@direct.upstate.edu

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.

Hospital & facility affiliations 2

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1770015190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4243",
            "fax_number": "315-464-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLAZA",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-464-4243",
            "fax_number": "315-464-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAXTON",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "311745-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.