Individual provider Active NPI

Dorenda Leigh Schmidt

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1902231475
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097766-01 Issued in NY
Practice address
1065 James St
Syracuse, NY 13203-2787
Phone
(315) 454-7400
NPI assigned
Sep 3, 2013
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105432 NY
Clinical Social Worker 1041C0700X 097766-01 NY Primary

Addresses

Primary practice location

1065 James St
Syracuse, NY 13203-2787

Mailing address

742 James St
Syracuse, NY 13203-2017
Phone (315) 703-2700

Other practice location 1

1065 James St
Syracuse, NY 13203-2787
Phone (315) 454-4700

Other practice location 2

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5491

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716004712 NY Practitioner - Clinical Social Worker 7517402373 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105432NYMDSocial Worker
097766-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Pathology, PC Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Jun 3, 2024 Accepting new patients
St Josephs Medical PC Past Accepting new patients
Bobbi L Petranchuk LCSW PLLC Clinical Past Accepting new patients

Locations

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1902231475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032017",
            "telephone_number": "315-703-2700",
            "fax_number": "315-703-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032787",
            "telephone_number": "315-454-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 James St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132032787",
            "country_code": "US",
            "telephone_number": "315-454-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132031807",
            "country_code": "US",
            "telephone_number": "315-448-5491",
            "fax_number": "315-448-6203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "DORENDA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105432",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097766-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.