NPIMap

Individual provider Active NPI

Michael R Ronald, RN FNP, RNFA

  • Emergency Medicine Physician
  • Ithaca, NY
National Provider Identifier
1871507905
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
331855 Issued in NY
Practice address
10 Brentwood Dr
Suite B
Ithaca, NY 14850-1865
Phone
(607) 266-0073
Fax
(607) 266-9310
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F331855 NY
Emergency Medicine Physician 207P00000X 331855 NY Primary

Addresses

Primary practice location

10 Brentwood Dr
Suite B
Ithaca, NY 14850-1865

Mailing address

10 Brentwood Dr
Suite B
Ithaca, NY 14850-1865
Phone (607) 266-0073

Other identifiers 1

IdentifierTypeStateIssuer
02266791MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070626000484 NY Practitioner - Nurse Practitioner 4385743772 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4296

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5480

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
331855NYMDEmergency Medicine Physician
F331855NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Physician Health, P.C. CurrentSince Feb 25, 2017 Accepting new patients
North Medical PC Emergency Medicine Current Accepting new patients
St Josephs Medical PC Emergency Medicine CurrentSince Jan 3, 2018 Accepting new patients
Chemung Medical Services PC Emergency Medicine Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

Interoperability endpoints

  • Direct secure messaging: mronald2389737@direct.trinity-health.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1871507905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRENTWOOD DR",
            "address_2": "SUITE B",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501865",
            "telephone_number": "607-266-0073",
            "fax_number": "607-266-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BRENTWOOD DR",
            "address_2": "SUITE B",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501865",
            "telephone_number": "607-266-0073",
            "fax_number": "607-266-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONALD",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "RN FNP, RNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F331855",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "331855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02266791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.