Individual provider Active NPI

Gabriella Autumn Pladocostante

  • Medical Physician Assistant
  • Utica, NY
National Provider Identifier
1982313656
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
029327 Issued in NY
Practice address
117 Business Park Dr
Utica, NY 13502-6303
Phone
(315) 798-1832
Fax
(315) 798-1432
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 029327 NY Primary

Addresses

Primary practice location

117 Business Park Dr
Utica, NY 13502-6303

Mailing address

117 Business Park Dr
Utica, NY 13502-6303
Phone (315) 798-1832

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
I20230117002930 NY Practitioner - Physician Assistant 1355712001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Slocum Dickson Medical Group PLLCGroup PAC ID 5799778510, 79 clinicians

Practice addresses (Care Compare)

117 Business Park Dr
Utica, NY 13502-6303
Phone (315) 798-1500

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029327NYMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: gpladocostante32636@mvhealthsystem.direct-ci.com

Organizations & group practices 1

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1982313656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026303",
            "telephone_number": "315-798-1832",
            "fax_number": "315-798-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026303",
            "telephone_number": "315-798-1832",
            "fax_number": "315-798-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLADOCOSTANTE",
        "first_name": "GABRIELLA",
        "middle_name": "AUTUMN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "029327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.