Pediatric Service Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC SERVICE GROUP

Practice address

750 E. Adams St.
5TH Floor
Syracuse, NY 13210

Phone

(315) 464-5450

Fax

(315) 464-7564

NPI assigned

May 26, 2006

Last updated

Oct 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Welch, MDNPI 1275577348

Title

Chairman of Department

Phone

(315) 464-5450

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 145

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melanie A Comito, MD

  • Pediatric Hematology & Oncology Physician
  • Syracuse, NY
  • NPI 1932152782
  Medicare reassignment Care Compare group NPD
• Andrea Marie Dvorak, M.D.

  • Pediatric Hematology & Oncology Physician
  • Syracuse, NY
  • NPI 1811154347

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Brooke Lee Fraser, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
  • NPI 1447771795
  Medicare reassignment Care Compare group NPD
• Courtney Roler Mauzy IV, BCBA PHD

  • Psychologist
  • Syracuse, NY
  • NPI 1366228025
  Medicare reassignment Care Compare group NPD
• Angela Patricia Mojica Sanabria, MD

  • Pediatric Endocrinology Physician
  • Syracuse, NY
  • NPI 1487949913

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Christina Nicolais, PHD

  • Psychologist
  • Syracuse, NY
  • NPI 1164905295
  Medicare reassignment Care Compare group NPD
• Jenica O'Malley, DO

  • Pediatrics Physician
  • Syracuse, NY
  • NPI 1285995324
  Medicare reassignment Care Compare group NPD
• Joan Elizabeth Pellegrino, MD

  • Clinical Genetics (M.D.) Physician
  • Syracuse, NY
  • NPI 1407876584
  Medicare reassignment Care Compare group NPD
• Marcus Richard Rivera, MD

  • Pediatric Gastroenterology Physician
  • Syracuse, NY
  • NPI 1891993218
  Medicare reassignment Care Compare group NPD
• Scott John Schurman, MD

  • Pediatric Nephrology Physician
  • Syracuse, NY
  • NPI 1821038548
  Medicare reassignment Care Compare group NPD
• Jody Loretta Sima, M.D.

  • Pediatric Hematology & Oncology Physician
  • Syracuse, NY
  • NPI 1285821132
  Medicare reassignment Care Compare group NPD
• Thomas R Welch, MD

  • Pediatric Nephrology Physician
  • Gainesville, FL
  • NPI 1275577348

  NY, Pediatrics

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1770539066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E. ADAMS ST.",
            "address_2": "5TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5450",
            "fax_number": "315-464-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E. ADAMS ST.",
            "address_2": "5TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5450",
            "fax_number": "315-464-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHAIRMAN OF DEPARTMENT",
        "authorized_official_telephone_number": "315-464-5450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01215750",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse L Peck, MSPT
• Bethany Ann Pecora-Sanefski
• Janice Morey Pedersen, NP
• Megan Pedersen
• Pediatric Cardiology Associates, LLC
• Trish Pedrosa, FNP
• Clarissa Pedrotti, LMSW
• Gideon James Peet, MD
• Jocelyn Peet, FNP
• Zakiyyah Peet, MS, LCAT, ATR-BC

• Pediatrics Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.