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NORTHWAY MEDICAL
NPI 1356765689
Non-Pharmacy Dispensing Site in Fulton, NY

Active since February 06, 2014CLIA 33D0165658 · Microscopy

NPPES record last updated: February 6, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northway Medical NPPES

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

NORTHWAY MEDICAL (NPI 1356765689) is a healthcare organization registered as a non-pharmacy dispensing site in Fulton, New York and active in the NPI registry since February 2014. The organization holds a CLIA Microscopy certificate valid through December 18, 2026 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1356765689
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameNORTHWAY MEDICAL ASSOCIATES PLLC
Location Address21 N 2ND STFulton, NY 13069-1250
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(315) 598-7105
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateFebruary 6, 2014
✔ NPI 1356765689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in NY · 211928
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
21 N 2ND ST, Fulton, NY 13069
Open in Google Maps ↗

Other Names 1

Doing Business AsNorthway Medical

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 for Provider-Performed Microscopy Procedures (PPMP) 33D0165658

Northway Medical Associates PLLC · Fulton, NY
Active · expires Dec 18, 2026
CLIA Number33D0165658
Laboratory TypePhysician Office
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorDr. Rajeev Z. Saini
Laboratory Phone(315) 598-7105
Laboratory LocationNorthway Medical Associates PLLC21 N Second Street, Fulton, NY 13069
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

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

MS. CLAIRE ANN VACCA N,P.
Nurse Practitioner (Pediatrics)
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
DR. RAJEEV SAINI M.D.
Internal Medicine
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
KATHERINE E MCPHEE NP
Nurse Practitioner (Family)
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
SHELLY L HOLLENBECK NP
Nurse Practitioner (Primary Care)
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
DR. SURYAKANT Z PATEL M.D.
Legal Medicine
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
ALICIA K BAIR MD
Internal Medicine
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
NORTHWAY MEDICAL ASSOCIATES, PLLC
Family Medicine
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105
MELISSA LYNN ROGERS FNP-BC
Nurse Practitioner (Family)
21 N 2ND ST
FULTON, NY 13069
Oswego County (315) 598-7105

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 Northway Medical Associates PLLC's NPI number?

The NPI number for Northway Medical Associates PLLC is 1356765689. It was assigned to this organization in the NPPES registry on February 6, 2014. The provider is doing business as Northway Medical.

Where is Northway Medical Associates PLLC located?

Northway Medical Associates PLLC is located at 21 N 2nd St, Fulton, NY 13069. The listed phone number is (315) 598-7105.

What is Northway Medical Associates PLLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Northway Medical Associates PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 33D0165658) is associated with this NPI, valid through December 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northway Medical Associates PLLC was last updated on February 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.