NPIMap

Individual provider Active NPI

Donald P. Penree Jr., RPA-C

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1780837468
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012929-1 Issued in NY
Practice address
3229 E Genesee St
Syracuse, NY 13214-2016
Phone
(315) 464-5726
Fax
(315) 464-2500
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012929-1 NY Primary

Addresses

Primary practice location

3229 E Genesee St
Syracuse, NY 13214-2016

Mailing address

3229 E Genesee St
Syracuse, NY 13214-2016
Phone (315) 464-5726

Other identifiers 1

IdentifierTypeStateIssuer
03081812MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090309000125 NY Practitioner - Physician Assistant 3577629054 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 Harrison St
Syracuse, NY 13202-3188
Phone (315) 464-8093

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-8093

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.04 of 100Reported as group
Quality
67.92
Promoting interoperability
99
Improvement activities
40
Cost
69.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012929-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse Physician Assistant CurrentSince Sep 19, 2019 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Sep 19, 2019 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Oct 28, 2018 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Oct 28, 2018 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Jul 5, 2012 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

3229 E Genesee St
Syracuse, NY 13214
Phone (315) 446-7501

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

Interoperability endpoints

  • Direct secure messaging: dpenree@oswegohealth.hiemail.healtheconnections.org
  • Direct secure messaging: dpenree11228@direct.upstate.edu

Organizations & group practices 10

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 3

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1780837468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132142016",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132142016",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENREE",
        "first_name": "DONALD",
        "middle_name": "P.",
        "name_suffix": "Jr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012929-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03081812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.