Active NPI
Judith B Dyne, NP
- Adult Medicine Physician
- Syracuse, NY
National Provider Identifier
1902893126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- F301606
- Practice address
- 1000 E Genesee St
Ste 300
Syracuse, NY 13210-1892 - Phone
- (315) 471-1044
- Fax
- (315) 474-4312
- NPI assigned
- Oct 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | F301606 | NY | Primary |
Addresses
Primary practice location
1000 E Genesee St
Ste 300
Syracuse, NY 13210-1892
Mailing address
1000 E Genesee St
Ste 300
Syracuse, NY 13210-1892
Phone (315) 471-1044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2310061 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F301606 | NY | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271030400000",
"number": "1902893126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E GENESEE ST",
"address_2": "STE 300",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101892",
"telephone_number": "315-471-1044",
"fax_number": "315-474-4312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E GENESEE ST",
"address_2": "STE 300",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101892",
"telephone_number": "315-471-1044",
"fax_number": "315-474-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYNE",
"first_name": "JUDITH",
"middle_name": "B",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-03",
"last_updated": "2010-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "NY",
"license": "F301606",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2310061",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.