MRS. JESSICA E PAONESSA (NPI# 1386760122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386760122 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA E PAONESSA |
| Other Name | MS. JESSICA ERIN STEVENS |
| Credential | MD |
| Practice Address |
4900 Broad Rd Syracuse NY 13215 |
| Mailing Address |
251 Salina Meadows Pkwy Ste 100 Syracuse NY 13212-4516 |
| Practice Telephone | 3154923700 |
| Practice Fax Number | 3154923596 |
| Mailing Telephone | 3154642000 |
| Mailing Fax Number | 3154642010 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 274692 | NY | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 01071233A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201112070 | 05 | |
| IN | ANTHEM PIN | 000000792827 | 01 |
| NY | 03884526 | 05 |
| Street Address |
4900 BROAD RD |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13215 |
| 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 |
| 1336667948 | Kristy Mcgough | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-04 |
| 1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
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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 | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962745133 | Jeffrey Villanueva | Urology | 725 Irvig Ave, Suite 403, Syracuse, NY 13210-2306 | 2013-04-05 |
| 1730483348 | Kenneth E. Hoogs Md PC | Urology | 100 Intrepid Lane, Syracuse, NY 13205 | 2010-12-23 |
| 1245530484 | Natasha Ginzburg | Urology | 750 East Adams, Syracuse, NY 13210-2306 | 2010-10-21 |
| 1629241864 | Associated Medical Professionals of Ny, Pllc | Urology | 4900 Broad Road Suite 3k, Community General Hospital Pob Building North, Syracuse, NY 13215 | 2008-04-09 |
| 1144338336 | Giora Katz | Urology | 550 Harrison St., Suite M, Syracuse, NY 13202 | 2006-08-28 |
| 1245296524 | J C Trussell | Urology | 750 East Adams Street, Upstate University Hospital, Syracuse, NY 13210 | 2006-04-25 |
| 1811992985 | Kenneth E Hoogs | Urology | 100 Intrepid Ln, Syracuse, NY 13205-2546 | 2005-06-16 |
| 1548789662 | Sergey Kravchick | Urology | 750 East Adams Street, Department of Urology Suny Upstate Medical University, Syracuse, NY 13210 | 2017-09-11 |
| 1962820977 | Ilija Aleksic | Urology | 1226 E Water St, Syracuse, NY 13210 | 2014-04-07 |
| 1598028466 | Scott V Wiener | Urology | 4900 Broad Road, Suite 4v, Syracuse, NY 13215 | 2012-06-16 |
| 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.