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DR. AUDREY VICTORIA VANDEWALL DO
NPI 1003343237
Pediatrics in Syracuse, NY

Active since May 18, 2017PECOS Enrolled
750 E ADAMS ST, SYRACUSE, NY 13210(315) 408-5854 Get Directions Write a Review

NPPES record last updated: October 10, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 10, 2022, May 18, 2017 (2 updates tracked since 2017).

About Dr. Audrey Victoria Vandewall Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AUDREY VICTORIA VANDEWALL DO (NPI 1003343237) is an individual pediatrics provider in Syracuse, New York, licensed in Michigan (5101025536) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003343237
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. AUDREY VICTORIA VANDEWALLCredential: DO
Location Address750 E ADAMS STSyracuse, NY 13210-2306
Mailing Address750 E Adams StSyracuse, NY 13210-2306
Phone(315) 408-5854
Sole ProprietorYes
Enumeration DateMay 18, 2017
Last NPPES UpdateOctober 10, 20222 updates tracked since enumeration
NPPES CertifiedOctober 10, 2022
✔ NPI 1003343237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 5101025536
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
750 E ADAMS ST, Syracuse, NY 13210
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Audrey Victoria Vandewall Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Audrey Vandewall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Pittsburgh Physicians
220 mi
Urgent Care
464 ALLEGHENY BLVD, PENNWOOD CENTER
Franklin, PA 16323
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7,114 clinicians in this Medicare group
NPI 1619381456 (814) 432-9801
University Pediatricians
355 mi
Nurse Practitioner
3901 BEAUBIEN
Detroit, MI 48201
  • Reassigned Medicare billing, Michigan enrollment
  • 360 clinicians in this Medicare group
NPI 1033143904 (313) 745-5214

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID M KANTER MD
Physical Medicine & Rehabilitation
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5820
BRENNAN ELLIS M.D.
Emergency Medicine
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6202
UPSTATE UROLOGY, INC.
Urology
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6106
BETHANY A HAWKE MD
Emergency Medicine
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-4363
BILLAL MOHMAND MD
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5240
DAYANA NASR MD
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5240
JARROD THOMAS ELLIS
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6635
PAIGE MORGAN MILLER MD
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-4472

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Audrey Vandewall's NPI number?

The NPI number for Audrey Vandewall is 1003343237. It was assigned to this individual provider in the NPPES registry on May 18, 2017.

Where is Audrey Vandewall located?

Audrey Vandewall practices at 750 E Adams St, Syracuse, NY 13210. The listed phone number is (315) 408-5854.

What is Audrey Vandewall's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Audrey Vandewall enrolled in Medicare?

Yes. Audrey Vandewall is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Audrey Vandewall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Audrey Vandewall reassigns Medicare benefits to 2 organizations: University Of Pittsburgh Physicians (Franklin, PA) and University Pediatricians (Detroit, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Audrey Vandewall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Audrey Vandewall was last updated on October 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.