Organization Active NPI

Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
National Provider Identifier
1205104262
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP
Practice address
82 Copeland Ave
Homer, NY 13077-1528
Phone
(607) 749-2640
Fax
(607) 749-2644
NPI assigned
Dec 6, 2011
Last updated
Sep 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Authorized official

Name
Michael IannuzziNPI 1376575597
Title
MD
Phone
(315) 464-3835

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

82 Copeland Ave
Homer, NY 13077-1528

Mailing address

82 Copeland Ave
Homer, NY 13077-1528
Phone (607) 749-2640

Other identifiers 1

IdentifierTypeStateIssuer
00459903MedicaidNY

Other names 1

  • University Physicians - Homer Other name

National Provider Directory

National Provider Directory

Locations

5700 W Genesee St
Ste 128
Camillus, NY 13031
Phone (315) 488-2372

6420 Yorktown Cir
East Syracuse, NY 13057
Phone (315) 432-4488

5112 W Taft Rd
Ste J
Liverpool, NY 13088
Phone (315) 701-2170

603 Seneca St
Ste 2
Oneida, NY 13421
Phone (315) 361-1041

1000 E Genesee St
Ste 205
Syracuse, NY 13210
Phone (315) 464-1600

4900 Broad Rd
Ste 4CNORTH
Syracuse, NY 13215
Phone (315) 492-5804

550 Harrison St
Ste 300
Syracuse, NY 13202
Phone (315) 464-1500

725 Irving Ave
#301
Syracuse, NY 13210
Phone (315) 464-5533

725 Irving Ave
Ste 211
Syracuse, NY 13210
Phone (315) 464-5533

725 Irving Ave
Ste 302
Syracuse, NY 13210
Phone (315) 464-5538

739 Irving Ave
Ste 520
Syracuse, NY 13210
Phone (315) 470-1051

90 Presidential Plz
#5010
Syracuse, NY 13202
Phone (315) 464-9335

90 Presidential Plz
#A
Syracuse, NY 13202
Phone (315) 464-3866

Practitioners & affiliated clinicians

Practitioners 479

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 479

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1205104262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 COPELAND AVE",
            "city": "HOMER",
            "state": "NY",
            "postal_code": "130771528",
            "telephone_number": "607-749-2640",
            "fax_number": "607-749-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 COPELAND AVE",
            "city": "HOMER",
            "state": "NY",
            "postal_code": "130771528",
            "telephone_number": "607-749-2640",
            "fax_number": "607-749-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "IANNUZZI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "315-464-3835"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Physicians - Homer",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Homer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.