Individual provider Active NPI

Mahesh Padmanabhan, MD

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1073504577
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
237715-1 Issued in NY
Practice address
800 Irving Ave
Syracuse, NY 13210-2716
Phone
(315) 425-4400
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 237715-1 NY Primary

Addresses

Primary practice location

800 Irving Ave
Syracuse, NY 13210-2716

Mailing address

120 Hobart St
Utica, NY 13501-4308
Phone (315) 798-1149

Other practice location 1

120 Hobart St
Utica, NY 13501-4308
Phone (315) 798-1149

Other identifiers 1

IdentifierTypeStateIssuer
02721451MedicaidNY

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
I20151109001877 NY Order and Referring Only - Family PracticePractitioner - Family Practice 4284652959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237715-1NYMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: maheshpad@hiemail.healtheconnections.org

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1073504577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HOBART ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014308",
            "telephone_number": "315-798-1149",
            "fax_number": "315-734-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135014308",
            "country_code": "US",
            "telephone_number": "315-798-1149",
            "fax_number": "315-734-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADMANABHAN",
        "first_name": "MAHESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "237715-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02721451",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.