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NIENKE PRINS DOSA MD
NPI 1063435774
Pediatrics - Neurodevelopmental Disabilities in Syracuse, NY

Active since July 25, 2006PECOS Enrolled
725 IRVING AVE, CROUSE POB, SYRACUSE, NY 13210(315) 464-4842(315) 464-7564 Get Directions Write a Review

NPPES record last updated: September 14, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Nienke Prins Dosa Md NPPES

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

NIENKE PRINS DOSA MD (NPI 1063435774) is an individual neurodevelopmental disabilities provider in Syracuse, New York, licensed in New York (205943) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063435774
Entity TypeIndividualFemale
Primary Taxonomy2080P0008X
Provider Legal NameNIENKE PRINS DOSACredential: MD
Location Address725 IRVING AVE, CROUSE POBSyracuse, NY 13210-1603
Mailing Address725 Irving Ave, Crouse PobSyracuse, NY 13210-1603 · (315) 464-4842 · Fax (315) 464-7564
Phone(315) 464-4842
Fax(315) 464-7564
Sole ProprietorNo
Enumeration DateJuly 25, 2006
Last NPPES UpdateSeptember 14, 2012
✔ NPI 1063435774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neurodevelopmental DisabilitiesAllopathic & Osteopathic Physicians
Taxonomy Code2080P0008X
License✔ Licensed in NY · 205943
Definition
A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.
725 IRVING AVE, Syracuse, NY 13210
Open in Google Maps ↗

Other Identifiers 3

Medicare PINJ400009704NY
Medicare UPINH56613NY
Medicaid02242377NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nienke Prins Dosa Md 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 Reassignment

Medicare enrollment records show Nienke Dosa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pediatric Service Group
0.3 mi
Pediatrics
750 E. ADAMS ST., 5TH FLOOR
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 131 clinicians in this Medicare group
NPI 1770539066 (315) 464-5450

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

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.

DR. FARUK OKTEM
Pediatrics (Pediatric Nephrology)
725 IRVING AVE, STE 805
SYRACUSE, NY 13210
Onondaga County (315) 464-6340
LAWRENCE S CHIN M.D.
Neurological Surgery
725 IRVING AVE, STE. 503
SYRACUSE, NY 13210
Onondaga County (315) 464-4470
LEAH KAUFMAN MD
Obstetrics & Gynecology
725 IRVING AVE, STE 600
SYRACUSE, NY 13210
Onondaga County (315) 464-5162
LAWRENCE RAYMOND SHOEMAKER MD
Pediatrics (Pediatric Nephrology)
725 IRVING AVE
SYRACUSE, NY 13210
Onondaga County (315) 464-6340
SUHAS V. PRADHAN M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
725 IRVING AVE, STE 514
SYRACUSE, NY 13210
Onondaga County (315) 475-8409
EMMA ELIZABETH PATELLO MD
Obstetrics & Gynecology
725 IRVING AVE, STE 600
SYRACUSE, NY 13210
Onondaga County (315) 464-5162
DAVID P PAAR MD
Internal Medicine (Infectious Disease)
725 IRVING AVE, STE 311
SYRACUSE, NY 13210
Onondaga County (315) 464-5533
JUDITH MARTGARET REES NP
Nurse Practitioner (Adult Health)
725 IRVING AVE, SUITE # 304
SYRACUSE, NY 13210
Onondaga County (315) 464-5533

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 Nienke Dosa's NPI number?

The NPI number for Nienke Dosa is 1063435774. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Nienke Dosa located?

Nienke Dosa practices at 725 Irving Ave Crouse Pob, Syracuse, NY 13210. The listed phone number is (315) 464-4842.

What is Nienke Dosa's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neurodevelopmental Disabilities, with taxonomy code 2080P0008X.

Is Nienke Dosa enrolled in Medicare?

Yes. Nienke Dosa is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nienke Dosa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nienke Dosa reassigns Medicare benefits to Pediatric Service Group (Syracuse, NY). The 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 Nienke Dosa'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 Nienke Dosa was last updated on September 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.