Individual provider Active NPI

David Wilson Wormuth, M.D., M.P.H.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • East Syracuse, NY
National Provider Identifier
1053371344
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
218591 Issued in NY
Practice address
5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone
(315) 234-7860
Fax
(315) 634-5170
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 218591 NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249

Mailing address

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone (315) 234-7860

Other identifiers 2

IdentifierTypeStateIssuer
02091129MedicaidNY
P00446825OtherNYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000645 NY Practitioner - Thoracic SurgeryPractitioner - General Surgery 2365523891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

104 Union Ave
Syracuse, NY 13203-1843

104 Union Ave
Syracuse, NY 13203-1846

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

  • HCR Home Care Home health agency, East Syracuse, NY, CCN 337119
  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Pathology, PC Current Accepting new patients
North Medical PC Current Accepting new patients
St Joseph'S Hospital Health Center CurrentSince Aug 9, 2025 Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: dwormuth2386974@direct.trinity-health.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1053371344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-234-7860",
            "fax_number": "315-634-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-234-7860",
            "fax_number": "315-634-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMUTH",
        "first_name": "DAVID",
        "middle_name": "WILSON",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "218591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02091129",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00446825",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.