Individual provider Active NPI

Alexandria M Cobb, RPA-C

  • Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1821335704
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016333 Issued in NY
Practice address
5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone
(315) 472-7504
Fax
(315) 634-4677
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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 016333 NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy
East Syracuse, NY 13057

Mailing address

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Other names 1

  • Alexandria M Bann Former name

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
I20130502000006 NY Practitioner - Physician Assistant 4284871682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

5490 Cobbler Way
Camillus, NY 13031-4309
Phone (315) 472-7504

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016333NYMDSpeech-Language Pathologist

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": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1821335704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "ALEXANDRIA",
        "middle_name": "M",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRIA",
            "last_name": "BANN",
            "middle_name": "M",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.