KRISTY MCGOUGH (NPI# 1336667948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336667948 |
| Entity Type | Individual |
| Full Name | KRISTY MCGOUGH |
| Practice Address |
4900 Broad Rd Syracuse NY 13215-2265 |
| Mailing Address |
204 Wilshire Rd Syracuse NY 13209-2251 |
| Practice Telephone | 3154925011 |
| Enumeration Date | 2017-09-04 |
| Last Update Date | 2017-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
021252 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4900 BROAD RD |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13215-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336143221 | David C Canfield | Anesthesiology | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2005-06-08 |
| 1205474335 | Meaghan Porter | Physical Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-12-19 |
| 1982262655 | Ryan Christopher Staib | Nurse Anesthetist, Certified Registered | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-05-29 |
| 1164989505 | Jessica Detor | Social Worker | 4900 Broad Rd, Physician Office Building North 3n, Syracuse, NY 13215-2265 | 2019-02-21 |
| 1316402415 | Oleksandr Kaplun | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-02-04 |
| 1003390204 | Ianna Javier Garcia | Occupational Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-24 |
| 1194207241 | Rebekah Schu | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-05 |
| 1669990065 | Katrina E Garrigan | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-06 |
| 1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
| 1821525296 | Cara Buchanan | Student in an Organized Health Care Education/Training Program | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367785 | Jeffrey Alan Gaulrapp | Registered Nurse | Upstate University Hospital Community General Campus, 4900 Broad Road, Syracuse, NY 13215 | 2020-05-08 |
| 1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
| 1083004907 | Roger G Levine Md | Psychiatric Residential Treatment Facility | 4914 West Seneca Turnpkie, Syracuse, NY 13215 | 2015-01-30 |
| 1558771071 | Edleanna Robinson | Licensed Practical Nurse | 5075 W Seneca Turnpike, Syracuse, NY 13215 | 2014-05-06 |
| 1689013450 | Rhonda Lee Philopena | Emergency Medicine | 4900 Broad Rd 1st Fl, Syracuse, NY 13215 | 2013-06-14 |
| 1962778498 | Marie Anne Stevens | Licensed Practical Nurse | 4057 Seneca Tpk, Van Duyn Home and Hospital, Syracuse, NY 13215 | 2012-03-29 |
| 1033439088 | Anna-marie Simpson | Chiropractor | 4922 W Seneca Tpke, Syracuse, NY 13215 | 2010-06-01 |
| 1992028690 | A John Wylie | Pharmacist | 4840 Sherwood Dr., Syracuse, NY 13215 | 2010-03-09 |
| 1669616512 | Asalim A Thabet | Emergency Medicine | 4900 Braod Rd, 1st Fl, Syracuse, NY 13215 | 2009-04-22 |
| 1992948707 | Jesse Reed Gutnick | Surgery | 4900 Borad Rd, Suite 23 North, Syracuse, NY 13215 | 2009-04-08 |
| Find all providers in zip 13215 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1760043574 | Colin Michael King | Physician Assistant | 135 Somerset Rd, Syracuse, NY 13224-1961 | 2019-06-24 |
| 1346657251 | Jessica Lynn Demauro | Physician Assistant | 111 Waverly Avenue, Syracuse, NY 13244 | 2014-07-14 |
| 1982664876 | Vincent M. Gemelli | Physician Assistant | 1304 Buckley Road, Suite 302, Syracuse, NY 13212-4318 | 2006-03-24 |
| 1245210129 | Benjamin I Connor | Physician Assistant | 2700 Court St, Syracuse, NY 13208-3295 | 2006-01-18 |
| 1326020033 | Michelle Margaret Ederer | Physician Assistant | 3504 W Genesee St, Syracuse, NY 13219-2008 | 2005-11-17 |
| 1689672230 | Robert D Kirk | Physician Assistant | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1892 | 2005-07-08 |
| 1992702278 | Michael P Sharak | Physician Assistant | 90 Presidential Plz, Firm B, Syracuse, NY 13202-2240 | 2005-07-01 |
| 1568022853 | Chelsea Clareann Yager | Physician Assistant | 301 Prospect Ave, Syracuse, NY 13203-1807 | 2019-06-18 |
| 1104308253 | Diana Maria Ramirez | Physician Assistant | 750 E Adams St, Syracuse, NY 13210-2306 | 2018-09-05 |
| Find all providers in SYRACUSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.