ALIDA ANNE DEJONG NP
NPI 1013912153
Nurse Practitioner - Family in Syracuse, NY

Q: What is Alida Dejong's NPI number?

The NPI number for Alida Dejong is 1013912153. It was assigned to this individual provider in the NPPES registry on June 16, 2005. The provider is also known as Alida Anne Kimmelman.

Q: What is Alida Dejong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Alida Dejong was last updated on December 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 16, 2005PECOS Enrolled

1045 JAMES ST, SYRACUSE, NY 13203(315) 472-4471(315) 472-1759 Get Directions Write a Review

NPPES record last updated: December 1, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Alida Anne Dejong Np NPPES

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

ALIDA ANNE DEJONG NP (NPI 1013912153) is an individual family provider in Syracuse, New York, licensed in New York (F333173-1) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013912153

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameALIDA ANNE DEJONGCredential: NP

Location Address1045 JAMES STSyracuse, NY 13203-2730

Mailing Address1045 James StSyracuse, NY 13203-2730 · (315) 472-4471 · Fax (315) 472-1759

Phone(315) 472-4471

Fax(315) 472-1759

Sole ProprietorNo

Enumeration DateJune 16, 2005

Last NPPES UpdateDecember 1, 2015

✔ NPI 1013912153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · F333173-1

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License 482368-1 (NY)

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License F302146-1 (NY)

1045 JAMES ST, Syracuse, NY 13203

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Other Names 1

Other Name (5)Alida Anne Kimmelman

Other Identifiers 3

Medicare UPINP80013NY

Medicaid02629216NY

Medicare PINJ400220510

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alida Anne Dejong Np 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13203 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.

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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.

ANDREA ROSA VERGARA LCSW

Social Worker (Clinical)