Individual provider Active NPI

Michael Lioudis, M.D.

  • Nephrology Physician
  • Camillus, NY
National Provider Identifier
1073729463
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
310114 Issued in NY
Practice address
208 Township Blvd
Camillus, NY 13031-1786
Phone
(315) 551-6000
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT185140 PA
Nephrology Physician 207RN0300X 310114 NY Primary

Addresses

Primary practice location

208 Township Blvd
Camillus, NY 13031-1786

Mailing address

251 Salina Meadows Pkwy Ste 100
Syracuse, NY 13212-4516
Phone (315) 464-2014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091001000559 OH Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 1052457298 Reassigns benefits to 1 organization
I20210609000976 NY Practitioner - Nephrology 1052457298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

90 Presidential PLZ
Firmc
Syracuse, NY 13202-2240
Phone (315) 464-5788

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
87.56 of 100Reported as group
Quality
71.97
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310114NYMDNephrology Physician
MT185140PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Service Group CurrentSince Jul 1, 2021 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Nephrology CurrentSince Jul 1, 2021 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

21 Nelson St
Auburn, NY 13021
Phone (315) 255-9004

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

90 Presidential Plz
#C
Syracuse, NY 13202
Phone (315) 464-3834

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

Interoperability endpoints

  • Direct secure messaging: mlioudismd27863@direct.ccf.org
  • Direct secure messaging: mlioudis119390@direct.upstate.edu

Organizations & group practices 4

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 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1073729463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PKWY STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124516",
            "telephone_number": "315-464-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 TOWNSHIP BLVD",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311786",
            "telephone_number": "315-551-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOUDIS",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT185140",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "310114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

Verify at the official NPI Registry.