NPIMap

Organization Active NPI

Associated Medical Professionals of Ny, PLLC

  • Urology Physician
  • Camillus, NY
National Provider Identifier
1861838708
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Practice address
5700 W Genesee St
Suite 105
Camillus, NY 13031-3200
Phone
(315) 478-4185
Fax
(315) 478-0840
NPI assigned
May 20, 2013
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Dr. Angelo R. Derosalia, MDNPI 1649444183
Title
Ceo
Phone
(315) 458-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

5700 W Genesee St
Suite 105
Camillus, NY 13031-3200

Mailing address

100 Metropolitan Park Dr.
Suite 100
Liverpool, NY 13088-5842
Phone (315) 870-9370

National Provider Directory

National Provider Directory
Part of
Associated Medical Professionals of Ny PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1861838708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR.",
            "address_2": "SUITE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885842",
            "telephone_number": "315-870-9370",
            "fax_number": "315-558-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "SUITE 105",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "enumeration_date": "2013-05-20",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "DEROSALIA",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-458-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.