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MADISON IRVING PEDIATRICS, PC
NPI 1063576312
Pediatrics - Adolescent Medicine in East Syracuse, NY

Active since December 21, 2006CLIA 33D0166138 · Waiver
6711 TOWPATH RD STE 235, EAST SYRACUSE, NY 13057(315) 471-2646(315) 471-1762 Get Directions Write a Review

NPPES record last updated: June 11, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 11, 2024, Nov 17, 2022 (2 updates tracked since 2022).

About Madison Irving Pediatrics, Pc NPPES

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

MADISON IRVING PEDIATRICS, PC (NPI 1063576312) is a healthcare organization registered as an adolescent medicine in East Syracuse, New York and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through February 17, 2027, maintains 2 additional practice locations, and lists Janessa Toole, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1063576312
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameMADISON IRVING PEDIATRICS, PC
Location Address6711 TOWPATH RD STE 235East Syracuse, NY 13057-9509
Mailing Address6711 Towpath Rd Ste 235East Syracuse, NY 13057-9509 · (315) 471-2646 · Fax (315) 471-1762
Phone(315) 471-2646
Fax(315) 471-1762
Organization SubpartNo
Authorized OfficialJanessa ToolePractice Manager · (315) 898-2643
Enumeration DateDecember 21, 2006
Last NPPES UpdateJune 11, 20242 updates tracked since enumeration
NPPES CertifiedJune 11, 2024
✔ NPI 1063576312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

6711 TOWPATH RD STE 235, East Syracuse, NY 13057
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Secondary Practice Locations 2

Location 1475 Irving Ave, Suite 210Syracuse, NY 13210-1756 · Phone (315) 471-2646 · Fax (315) 471-1762
Location 25900 N Burdick St Ste 215East Syracuse, NY 13057-9465 · Phone (315) 656-8750 · Fax (315) 656-8493

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0166138

Madison Irving Pediatrics, PC East Side Pediatrics · East Syracuse, NY
Active · expires Feb 17, 2027
CLIA Number33D0166138
Laboratory TypePhysician Office
Certificate Effective DateFebruary 18, 2025
Certificate Expiration DateFebruary 17, 2027
Laboratory DirectorDr. Megan L. Campbell
Laboratory Phone(315) 471-2646
Laboratory LocationMadison Irving Pediatrics, PC East Side Pediatrics6711 Towpath Road Suite 235, East Syracuse, NY 13057
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. KAVITA SETH DO
Pediatrics
6711 TOWPATH RD STE 235
EAST SYRACUSE, NY 13057
Onondaga County (315) 471-2646
DR. TAMORA I. GALLAGHER D.O.
Pediatrics
6711 TOWPATH RD STE 235
EAST SYRACUSE, NY 13057
Onondaga County (315) 471-2646
MARISSA NICOLE EDWARDS CPNP-PC
Nurse Practitioner (Pediatrics)
6711 TOWPATH RD STE 235
EAST SYRACUSE, NY 13057
Onondaga County (315) 471-2646

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 Madison Irving Pediatrics, PC's NPI number?

The NPI number for Madison Irving Pediatrics, PC is 1063576312. It was assigned to this organization in the NPPES registry on December 21, 2006.

Where is Madison Irving Pediatrics, PC located?

Madison Irving Pediatrics, PC is located at 6711 Towpath Rd Ste 235, East Syracuse, NY 13057. The listed phone number is (315) 471-2646.

What is Madison Irving Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Madison Irving Pediatrics, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0166138) is associated with this NPI, valid through February 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Madison Irving Pediatrics, PC was last updated on June 11, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.