Individual provider Active NPI

Scott C Buckingham, MD

  • Diagnostic Radiology Physician
  • Syracuse, NY
National Provider Identifier
1104826312
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
203094 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7551
Fax
(315) 470-2719
NPI assigned
Jul 29, 2005
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 203094 NY Primary
Vascular & Interventional Radiology Physician 2085R0204X 203094 NY

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

5008 Brittonfield Pkwy
Suite 100
East Syracuse, NY 13057-9248
Phone (315) 234-7600

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
I20040526000984 NY Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9436130382 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Area Hospital Inc CurrentSince Jul 1, 2021 Accepting new patients
Carthage Area Hospital Inc CurrentSince Jul 1, 2021 Accepting new patients
Crouse Radiology Associates LLP Diagnostic Radiology CurrentSince Dec 1, 2003 Accepting new patients
Medical Imaging Center LLP CurrentSince Apr 1, 2005 Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients

Locations

192 W Genesee St
Auburn, NY 13021
Phone (315) 258-5253

37 W Garden St
Ste 107
Auburn, NY 13021
Phone (315) 255-2828

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

3045 East Ave
Central Square, NY 13036
Phone (315) 668-1202

6 Euclid Ave
Cortland, NY 13045
Phone (607) 753-9076

5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 634-5056

5008 Brittonfield Pkwy
Ste 100
East Syracuse, NY 13057
Phone (315) 234-7609

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 150
Syracuse, NY 13210
Phone (315) 470-2985

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1104826312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-234-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7551",
            "fax_number": "315-470-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "203094",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "203094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.