Individual provider Active NPI

Ovid O. Neulander, M.D.

  • Specialist
  • Camillus, NY
National Provider Identifier
1174588685
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
144705 Issued in NY
Practice address
5700 W Genesee St
Ste. 201N
Camillus, NY 13031-3200
Phone
(315) 488-5588
Fax
(315) 488-2489
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 144705 NY Primary

Addresses

Primary practice location

5700 W Genesee St
Ste. 201N
Camillus, NY 13031-3200

Mailing address

5700 W Genesee St
Ste. 201N
Camillus, NY 13031-3200
Phone (315) 488-5588

Other identifiers 1

IdentifierTypeStateIssuer
00783211MedicaidNY

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
I20051012000882 NY Practitioner - General SurgeryPractitioner - Vascular Surgery 0042280414

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

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1174588685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "STE. 201N",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-5588",
            "fax_number": "315-488-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "STE. 201N",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-5588",
            "fax_number": "315-488-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEULANDER",
        "first_name": "OVID",
        "middle_name": "O.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "144705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783211",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

Verify at the official NPI Registry.