Individual provider Active NPI

Diego Villamizar, M.D.

  • Anesthesiology Physician
  • Syracuse, NY
National Provider Identifier
1083069496
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
30366701 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(772) 532-0240
NPI assigned
May 4, 2016
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 30366701 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

736 Irving Ave
Syracuse, NY 13210-1687

Other names 1

  • Dr. Diego Alejandro Villamizar I Professional name

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
I20200713001480 NY Practitioner - Anesthesiology 6608112412 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agcny Physicians PLLCGroup PAC ID 4284804345, 36 clinicians
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

260 Township Blvd
Suite 20
Camillus, NY 13031-1678
Phone (315) 708-0091

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 498-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30366701NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agcny Physicians PLLC Anesthesiology CurrentSince Oct 1, 2023 Accepting new patients
Syracuse Gastroenterological Associates PC Anesthesiology CurrentSince Sep 1, 2020 Accepting new patients
Syracuse Gastroenterological Associates.PC Current Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients
Chag Anesthesia PC Anesthesiology CurrentSince Oct 16, 2023 Accepting new patients
Syracuse Endoscopy Associates, LLC PastSince Jul 21, 2024 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

260 Township Blvd
Ste 20
Camillus, NY 13031
Phone (315) 708-0091

5700 W Genesee St
Ste 11
Camillus, NY 13031
Phone (315) 701-9378

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

5000 Campuswood Dr
Ste 200
East Syracuse, NY 13057

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

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

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

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

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

Interoperability endpoints

  • Direct secure messaging: dvillamizar51152@direct.upstate.edu

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1083069496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "772-532-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAMIZAR",
        "first_name": "DIEGO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "30366701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIEGO",
            "last_name": "VILLAMIZAR",
            "middle_name": "ALEJANDRO",
            "prefix": "DR.",
            "suffix": "I",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.