Individual provider Active NPI

Farzad Sarmast, MD

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1104014422
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
245840-1 Issued in NY
Practice address
1045 James St
Syracuse, NY 13203-2730
Phone
(315) 413-7865
Fax
(315) 679-5990
NPI assigned
Oct 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 245840 NY
Family Medicine Physician 207Q00000X 245840-1 NY Primary

Addresses

Primary practice location

1045 James St
Syracuse, NY 13203-2730

Mailing address

1045 James St
Syracuse, NY 13203-2730
Phone (315) 413-7865

Other identifiers 3

IdentifierTypeStateIssuer
1104014422MedicaidNY
02960052MedicaidNY
204494493OtherNYBLUE SHIELD

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
I20080421000027 NY Practitioner - Family PracticePractitioner - Emergency Medicine 4981782703 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245840NYMDEmergency Medicine Physician
245840-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Emergency Medicine CurrentSince Feb 23, 2020 Accepting new patients
Liberty Resources, Inc. CurrentSince Nov 14, 2016 Accepting new patients
Liberty Resources, Inc. CurrentSince Nov 14, 2016 Accepting new patients
Liberty Resources Inc. Current Accepting new patients
Cma Medical Practice PLLC Emergency Medicine CurrentSince Dec 31, 2019 Accepting new patients

Locations

1129 Commons Ave
#C
Cortland, NY 13045
Phone (607) 339-0456

510 S 4th St
Ste 2
Fulton, NY 13069
Phone (315) 592-3510

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

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

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1104014422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-413-7865",
            "fax_number": "315-679-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-413-7865",
            "fax_number": "315-679-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARMAST",
        "first_name": "FARZAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "245840",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "245840-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104014422",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02960052",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "204494493",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.