Individual provider Active NPI

Christopher Neil Fortner, MD, PHD

  • Pediatric Pulmonology Physician
  • Syracuse, NY
National Provider Identifier
1104084078
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
263942 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2342
Phone
(315) 464-5450
Fax
(315) 464-6322
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 110562 NC
Pediatric Pulmonology Physician 2080P0214X 263942 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2342

Mailing address

750 E Adams St
Syracuse, NY 13210-2342
Phone (315) 464-5450

Other identifiers 1

IdentifierTypeStateIssuer
03437170MedicaidNY

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
I20120419000173 NY Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 7113082017 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110562NCMDPediatric Pulmonology Physician
263942NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Allergy of Pulmonary Pediatric Pulmonology CurrentSince Mar 1, 2026 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Pediatric Service Group CurrentSince Apr 1, 2012 Accepting new patients
University of Rochester CurrentSince Mar 1, 2026 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Mar 1, 2026 Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

475 Irving Ave
Ste 90
Syracuse, NY 13210
Phone (315) 454-6323

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

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

Interoperability endpoints

  • Direct secure messaging: cfortner9237@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1104084078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-5450",
            "fax_number": "315-464-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-5450",
            "fax_number": "315-464-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "CHRISTOPHER",
        "middle_name": "NEIL",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NC",
            "license": "110562",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "263942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03437170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.