Individual provider Active NPI

Peter J Christiano, M.D.

  • Family Medicine Physician
  • East Syracuse, NY
National Provider Identifier
1114914090
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1738181 Issued in NY
Practice address
4939 Brittonfield Pkwy
East Syracuse, NY 13057-9208
Phone
(315) 463-1600
Fax
(315) 463-6793
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1738181 NY Primary

Addresses

Primary practice location

4939 Brittonfield Pkwy
East Syracuse, NY 13057-9208

Mailing address

4939 Brittonfield Pkwy
East Syracuse, NY 13057-9208
Phone (315) 463-1600

Other identifiers 1

IdentifierTypeStateIssuer
01918721MedicaidNY

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
I20060113000477 NY Practitioner - Family Practice 6608899885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4939 Brittonfield Pkwy
Suite 101
East Syracuse, NY 13057-9208

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1738181NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Family Care, LLP Family Medicine CurrentSince Aug 1, 2001 Accepting new patients

Locations

4939 Brittonfield Pkwy
Ste 101
East Syracuse, NY 13057
Phone (315) 463-1600

4939 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 463-1600

Interoperability endpoints

  • Direct secure messaging: pchristiano@cnyfamilycare.medentdirect.com

Organizations & group practices 1

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 2

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1114914090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-463-1600",
            "fax_number": "315-463-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-463-1600",
            "fax_number": "315-463-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANO",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "1738181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01918721",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.