NPIMap

Organization Active NPI

Digestive Disease Medicine of Central New York, LLP

  • Medical Specialty Clinic/Center
  • Utica, NY
National Provider Identifier
1083785372
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
DIGESTIVE DISEASE MEDICINE OF CENTRAL NEW YORK, LLP
Practice address
116 Business Park Drive
1St Floor
Utica, NY 13502-6313
Phone
(315) 624-7000
Fax
(315) 793-1129
NPI assigned
Nov 10, 2006
Last updated
Jun 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Bradley F Sklar, MDNPI 1003899261
Title
Owner
Phone
(315) 624-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

116 Business Park Drive
1St Floor
Utica, NY 13502-6313

Mailing address

116 Business Park Drive
1St Floor
Utica, NY 13502-6313
Phone (315) 624-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051207000321 NY Part B Supplier - Clinic/Group Practice 1254351141 Receives reassigned benefits from 22 practitioners
Practice locations: Utica, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1083785372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BUSINESS PARK DRIVE",
            "address_2": "1ST FLOOR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026313",
            "telephone_number": "315-624-7000",
            "fax_number": "315-793-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BUSINESS PARK DRIVE",
            "address_2": "1ST FLOOR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026313",
            "telephone_number": "315-624-7000",
            "fax_number": "315-793-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASE MEDICINE OF CENTRAL NEW YORK, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "SKLAR",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-624-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.