Organization Active NPI

Suhas V. Pradhan, M.D., P.C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Syracuse, NY
National Provider Identifier
1104131366
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
133288 Issued in NY
Legal business name
SUHAS V. PRADHAN, M.D., P.C.
Practice address
725 Irving Ave Ste 514
Syracuse, NY 13210-1683
Phone
(315) 475-8409
Fax
(315) 475-6026
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Dr. Suhas V. Pradhan, M.D.
Title
Owner
Phone
(315) 475-8409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X 133288 NY Primary

Addresses

Primary practice location

725 Irving Ave Ste 514
Syracuse, NY 13210-1683

Mailing address

725 Irving Ave Ste 514
Syracuse, NY 13210-1683
Phone (315) 475-8409

Other identifiers 1

IdentifierTypeStateIssuer
00458659MedicaidNY

National Provider Directory

National Provider Directory

Locations

725 Irving Ave
Ste 514
Syracuse, NY 13210
Phone (315) 475-8409

725 Irving Ave
Ste 541
Syracuse, NY 13210
Phone (315) 475-8409

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1104131366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 514",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101683",
            "telephone_number": "315-475-8409",
            "fax_number": "315-475-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 514",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101683",
            "telephone_number": "315-475-8409",
            "fax_number": "315-475-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUHAS V. PRADHAN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "PRADHAN",
        "authorized_official_first_name": "SUHAS",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-475-8409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "133288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00458659",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.