Individual provider Active NPI

Kristen Niver, PA-C

  • Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1891035648
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016125 Issued in NY
Practice address
5008 Brittonfield Pkwy
Suite 700
East Syracuse, NY 13057-9248
Phone
(315) 472-7504
Fax
(315) 634-4677
NPI assigned
Feb 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016125 NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy
Suite 700
East Syracuse, NY 13057-9248

Mailing address

5008 Brittonfield Pkwy
Suite 700
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Other identifiers 1

IdentifierTypeStateIssuer
03694020MedicaidNY

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
I20130820000519 NY Practitioner - Physician Assistant 5597907642 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital Health Center CurrentSince May 6, 2013 Accepting new patients

Locations

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

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

Organizations & group practices 5

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": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1891035648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIVER",
        "first_name": "KRISTEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03694020",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.