Individual provider Active NPI

Adrienne L Salomon, DO

  • Family Medicine Physician
  • Cortland, NY
National Provider Identifier
1881700177
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
241330 Issued in NY
Practice address
14 Kennedy Pkwy
Cortland, NY 13045-1435
Phone
(607) 756-9941
Fax
(315) 634-6789
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 241330 NY Primary

Addresses

Primary practice location

14 Kennedy Pkwy
Cortland, NY 13045-1435

Mailing address

14 Kennedy Pkwy
Cortland, NY 13045-1435
Phone (607) 756-9941

Other identifiers 1

IdentifierTypeStateIssuer
02816053MedicaidNY

Other names 1

  • Adrienne L Stevens Former name

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
I20070420000104 NY Practitioner - Family Practice 8123123148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241330NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Family Medicine CurrentSince Jan 2, 2018 Accepting new patients
Cayuga Medical Associates, PC CurrentSince Mar 1, 2021 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jan 2, 2018 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

14 Kennedy Pkwy
Cortland, NY 13045
Phone (607) 591-4429

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

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Organizations & group practices 6

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1881700177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KENNEDY PKWY",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451435",
            "telephone_number": "607-756-9941",
            "fax_number": "315-634-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 KENNEDY PKWY",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451435",
            "telephone_number": "607-756-9941",
            "fax_number": "315-634-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "ADRIENNE",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "241330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02816053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "STEVENS",
            "middle_name": "L",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.