NPIMap

Organization Active NPI

Nysarc Inc. Onondaga County Chapter

  • Developmental Disabilities Clinic/Center
  • Syracuse, NY
National Provider Identifier
1043397490
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
NYSARC INC. ONONDAGA COUNTY CHAPTER
Practice address
600 S Wilbur Ave
Syracuse, NY 13204-2730
Phone
(315) 476-7441
Fax
(315) 424-6001
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stanfort J. Perry
Title
Execuitive Director
Phone
(315) 476-7441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

600 S Wilbur Ave
Syracuse, NY 13204-2730

Mailing address

600 S Wilbur Ave
Syracuse, NY 13204-2730
Phone (315) 476-7441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070912000594 NY Part B Supplier - Clinic/Group Practice 9537252184 Receives reassigned benefits from 21 practitioners
Practice locations: Liverpool, NY; Watertown, NY; Syracuse, NY; Oneonta, NY; Norwood, NY; East Syracuse, NY; Canton, NY

National Provider Directory

National Provider Directory
Tax ID family
Nysarc Inc Onondaga County Chapter2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1043397490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S WILBUR AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042730",
            "telephone_number": "315-476-7441",
            "fax_number": "315-424-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S WILBUR AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042730",
            "telephone_number": "315-476-7441",
            "fax_number": "315-424-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSARC INC. ONONDAGA COUNTY CHAPTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "STANFORT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUITIVE DIRECTOR",
        "authorized_official_telephone_number": "315-476-7441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.