Adam W Paddock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017022 Issued in NY

Practice address

4000 Medical Center Dr
Fayetteville, NY 13066-6631

Phone

(315) 663-0100

Fax

(315) 663-0052

NPI assigned

Sep 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

State University of Ny Upstate Medical University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empire Dermatology PLLCGroup PAC ID 9234417452, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oswego Hospital Hospital, Oswego, NY, CCN 330218

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Empire Dermatology PLLC

  • MOHS-Micrographic Surgery Physician
  • East Syracuse, NY
  • NPI 1336698406
  Medicare reassignment Care Compare group
• Dr. Fazeli & Dr. Broumand LLC

  • Dermatology Physician
  • Fayetteville, NY
  • NPI 1336235639
  Medicare reassignment
• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1992131973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666631",
            "telephone_number": "315-663-0100",
            "fax_number": "315-663-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666631",
            "telephone_number": "315-663-0100",
            "fax_number": "315-663-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "ADAM",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navpriya Oberoi, MD
• Colleen Olszewski, FNP-C
• Mary Oot, FNP
• Tana Lynn Osada, R.N.
• John J Osborne, LCSW
• Painted Post, LLC
• Lindsey M Painter
• Sally A Palmer, NP
• Robert G Parke, MD
• Tamra A. Parker, LCSW-R

• Physician Assistant in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.