Individual provider Active NPI

Intikhab Iqbal, M.D.

  • Gastroenterology Physician
  • East Syracuse, NY
National Provider Identifier
1063650489
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
259109 Issued in NY
Practice address
5000 Campuswood Drive
Suite 200
East Syracuse, NY 13057
Phone
(315) 234-6677
Fax
(315) 234-4808
NPI assigned
Jan 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 259109 NY
Gastroenterology Physician 207RG0100X 259109 NY Primary

Addresses

Primary practice location

5000 Campuswood Drive
Suite 200
East Syracuse, NY 13057

Mailing address

5000 Campuswood Drive
Suite 200
East Syracuse, NY 13057
Phone (315) 234-6677

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
I20110415000223 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 1456404169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Syracuse Gastroenterological Associates.PCGroup PAC ID 6305814716, 35 clinicians

Practice addresses (Care Compare)

150 Broad St
Hamilton, NY 13346-9575
Phone (315) 824-7060

3045 John Trush Jr Blvd
Cazenovia, NY 13035-9556
Phone (315) 234-6677

5000 Campuswood Dr
Suite 200
East Syracuse, NY 13057-1268
Phone (315) 234-6677

5415 W Genesee St
Suite 203
Camillus, NY 13031-2162
Phone (315) 324-6677

739 Irving Ave
Suite 430
Syracuse, NY 13210-1653
Phone (315) 234-6677

Hospital & facility affiliations

  • Community Memorial Hospital, Inc Hospital, Hamilton, NY, CCN 331316
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
98.09 of 100Reported as group
Quality
97.07
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy199
Upper gastrointestinal (GI) endoscopy for acid reflux106

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Gastroenterological Associates PC CurrentSince Mar 15, 2011 Accepting new patients
Syracuse Endoscopy Associates, LLC CurrentSince Apr 7, 2011 Accepting new patients
Syracuse Gastroenterological Associates.PC Gastroenterology CurrentSince Mar 15, 2011 Accepting new patients

Locations

5415 W Genesee St
Ste 203
Camillus, NY 13031
Phone (315) 324-6677

3045 John Trush Jr Blvd
Cazenovia, NY 13035
Phone (315) 824-7040

5000 Campuswood Dr
Ste 200
East Syracuse, NY 13057

5000 Campuswood Dr
Ste 100
East Syracuse, NY 13057
Phone (315) 234-6687

5000 Campuswood Dr
East Syracuse, NY 13057

150 Broad St
Hamilton, NY 13346
Phone (315) 824-1100

739 Irving Ave
Ste 400
Syracuse, NY 13210
Phone (315) 234-4815

736 Irving Ave
Ste 430
Syracuse, NY 13210

739 Irving Ave
Ste 430
Syracuse, NY 13210

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

739 Irving Ave
Ste 420
Syracuse, NY 13210
Phone (315) 470-7921

Organizations & group practices 3

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 4

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": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1063650489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CAMPUSWOOD DRIVE",
            "address_2": "SUITE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-234-6677",
            "fax_number": "315-234-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CAMPUSWOOD DRIVE",
            "address_2": "SUITE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-234-6677",
            "fax_number": "315-234-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "INTIKHAB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "259109",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "259109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.