Individual provider Active NPI

Kandice M. Kowalewski, PA

  • Medical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1881609204
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0098221 Issued in NY
Practice address
770 James St
Suite 100
Syracuse, NY 13203-2117
Phone
(315) 422-2222
Fax
(315) 472-8497
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0098221 NY Primary

Addresses

Primary practice location

770 James St
Suite 100
Syracuse, NY 13203-2117

Mailing address

792 N Main St
Suite 100a
North Syracuse, NY 13212-1644
Phone (315) 423-9722

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
I20040623001289 NY Practitioner - Physician Assistant 7517942402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates for Women'S Medicine PLLCGroup PAC ID 4880677400, 17 clinicians

Practice addresses (Care Compare)

792 /2 N Main St
North Syracuse, NY 13212-1670
Phone (315) 701-0500

935 James St
Syracuse, NY 13203-2502
Phone (315) 422-2222

Hospital & facility affiliations

  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0098221NYMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kandice.kowalewskipa.awm@direct.awm.nextgenshare.com

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.

Hospital & facility affiliations 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1881609204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "SUITE 100A",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-423-9722",
            "fax_number": "315-423-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 JAMES ST",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032117",
            "telephone_number": "315-422-2222",
            "fax_number": "315-472-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALEWSKI",
        "first_name": "KANDICE",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0098221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.