Individual provider Active NPI

Scott M Vanvalkenburg, M.D.

  • Orthopaedic Surgery Physician
  • East Syracuse, NY
National Provider Identifier
1114181435
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
274789 Issued in NY
Practice address
6620 Fly Rd
Ste 200
East Syracuse, NY 13057-9791
Phone
(315) 464-4472
Fax
(315) 464-5229
NPI assigned
Jul 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 14250 RI
Orthopaedic Surgery Physician 207X00000X 274789 NY Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 274789 NY
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6620 Fly Rd
Ste 200
East Syracuse, NY 13057-9791

Mailing address

6620 Fly Road
Ste 200
E. Syracuse, NY 13057
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
I20140905000712 NY Practitioner - Orthopedic Surgery 1557502994 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Orthopedics, LLPGroup PAC ID 1456344514, 33 clinicians

Practice addresses (Care Compare)

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

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
274789NYMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Feb 12, 2022 Accepting new patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Sep 2, 2014 Accepting new patients
Auburn Community Hospital CurrentSince Feb 12, 2022 Accepting new patients
Upstate Community Medical, PC Orthopaedic Surgery CurrentSince Jan 28, 2017 Accepting new patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Sep 2, 2014 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

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

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

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

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

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

Interoperability endpoints

  • Direct secure messaging: svanvalkenburg6337@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.

Hospital & facility affiliations 1

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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1114181435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 FLY ROAD",
            "address_2": "STE 200",
            "city": "E. SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 FLY RD",
            "address_2": "STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579791",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVALKENBURG",
        "first_name": "SCOTT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "RI",
            "license": "14250",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "274789",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NY",
            "license": "274789",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.