Individual provider Active NPI

Craig M Hanifin, PA

  • Surgical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1881661221
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
010093 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7111
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 010093 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

PO Box 2001
East Syracuse, NY 13057-4501
Phone (315) 449-2208

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
I20050316000773 NY Practitioner - Physician Assistant 7517912108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310

5100 W Taft Rd
Liverpool, NY 13088-4841

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

5823 Widewaters Pkwy
Suite 3
East Syracuse, NY 13057-3081
Phone (315) 418-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
St Josephs Medical PC CurrentSince Feb 1, 2026 Accepting new patients

Locations

4000 Medical Center Dr
Ste 115
Fayetteville, NY 13066
Phone (315) 329-2555

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

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

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

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

Organizations & group practices 4

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1881661221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2001",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574501",
            "telephone_number": "315-449-2208",
            "fax_number": "315-362-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANIFIN",
        "first_name": "CRAIG",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.