Individual provider Active NPI

Victoria Rose Pirro

  • Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1801784475
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033895 Issued in NY
Practice address
5823 Widewaters Pkwy
East Syracuse, NY 13057-3084
Phone
(315) 500-7546
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 033895 NY Primary

Addresses

Primary practice location

5823 Widewaters Pkwy
East Syracuse, NY 13057-3084

Mailing address

6301 Matilda Gage
Cicero, NY 13039-7942

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827004658 NY Practitioner - Physician Assistant 2769983238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empire Dermatology PLLCGroup PAC ID 9234417452, 14 clinicians

Practice addresses (Care Compare)

5823 Widewaters Pkwy
Suite 4
East Syracuse, NY 13057-3081
Phone (315) 500-7546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033895NYMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1801784475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 MATILDA GAGE",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130397942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573084",
            "telephone_number": "315-500-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIRRO",
        "first_name": "VICTORIA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.