Active NPI
Gerard Conrad Richter, PA
- Surgical Physician Assistant
- Syracuse, NY
National Provider Identifier
1790858348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 003572-1
- Practice address
- 301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807 - Phone
- (315) 448-2876
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 003572-1 | NY | Primary |
Addresses
Primary practice location
301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807
Mailing address
301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807
Phone (315) 448-2876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003572-1 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204502400000",
"number": "1790858348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 PROSPECT AVE",
"address_2": "SURGICAL PA OFFICE ROOM 4202",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132031807",
"telephone_number": "315-448-2876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 PROSPECT AVE",
"address_2": "SURGICAL PA OFFICE ROOM 4202",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132031807",
"telephone_number": "315-448-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHTER",
"first_name": "GERARD",
"middle_name": "CONRAD",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2008-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "003572-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.