Individual provider Active NPI

Colleen Feeney, MD

  • Pediatrics Physician
  • Syracuse, NY
National Provider Identifier
1821626573
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
322856 Issued in NY
Practice address
725 East Adams St
4TH FL
Syracuse, NY 13210
Phone
(315) 464-5831
Fax
(315) 464-2030
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 322856 NY Primary

Addresses

Primary practice location

725 East Adams St
4TH FL
Syracuse, NY 13210

Mailing address

725 East Adams St
4TH FL
Syracuse, NY 13210
Phone (315) 464-5831

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606001073 NY Practitioner - Pediatric Medicine 1052778180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
322856NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Service Group Pediatrics CurrentSince Jul 19, 2023 Accepting new patients

Locations

8687 Carling Rd
Ste C
Liverpool, NY 13090

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

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

Interoperability endpoints

  • Direct secure messaging: cfeeney65165@direct.upstate.edu

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1821626573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 EAST ADAMS ST",
            "address_2": "4TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5831",
            "fax_number": "315-464-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 EAST ADAMS ST",
            "address_2": "4TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5831",
            "fax_number": "315-464-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEENEY",
        "first_name": "COLLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "322856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.