Individual provider Active NPI

Maria Iannolo, M.D.

  • Orthopaedic Surgery Physician
  • East Syracuse, NY
National Provider Identifier
1093954406
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
257969 Issued in NY
Practice address
6620 Fly Rd
East Syracuse, NY 13057-9717
Phone
(315) 464-4472
Fax
(315) 464-5222
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 257969 NY Primary

Addresses

Primary practice location

6620 Fly Rd
East Syracuse, NY 13057-9717

Mailing address

6620 Fly Rd
East Syracuse, NY 13057-9717
Phone (315) 464-4472

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
I20110825000336 NY Practitioner - Orthopedic Surgery 3870763055 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians
Upstate Orthopedics, LLPGroup PAC ID 1456344514, 33 clinicians
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

208 Township Blvd
Suite 200
Camillus, NY 13031-1674
Phone (315) 551-6000

510 S 4TH St
Suite 140
Fulton, NY 13069-2952
Phone (315) 349-5873

6620 Fly Rd
Suite 100
East Syracuse, NY 13057-4281
Phone (315) 484-4472

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.43 of 100Reported as group
Quality
90.7
Promoting interoperability
100
Improvement activities
40
Cost
80.73

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Aug 15, 2011 Accepting new patients
Physician Care PC Orthopaedic Surgery CurrentSince Aug 15, 2025 Accepting new patients
Auburn Community Hospital CurrentSince Jan 6, 2022 Accepting new patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince Jan 1, 2016 Accepting new patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Aug 15, 2011 Accepting new patients
Auburn Community Hospital CurrentSince Jan 6, 2022 Accepting new patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince Jan 1, 2016 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

208 Township Blvd
Ste 200
Camillus, NY 13031
Phone (315) 464-4472

6620 Fly Rd
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472

6620 Fly Rd
East Syracuse, NY 13057
Phone (315) 464-1849

6620 Fly Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 464-4472

510 S 4th St
Ste 140
Fulton, NY 13069
Phone (315) 349-5873

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Interoperability endpoints

  • Direct secure messaging: miannolo@amms.medentdirect.com
  • Direct secure messaging: miannolo6908@direct.upstate.edu

Organizations & group practices 8

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 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": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1093954406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 FLY RD",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579717",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 FLY RD",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579717",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNOLO",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "257969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.