Individual provider Active NPI

J C Trussell, M.D.

  • Urology Physician
  • Syracuse, NY
National Provider Identifier
1245296524
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
253896 Issued in NY
Practice address
750 East Adams Street
Upstate University Hospital
Syracuse, NY 13210
Phone
(315) 464-6031
Fax
(315) 464-6117
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD418317 PA
Urology Physician 208800000X 253896 NY Primary

Addresses

Primary practice location

750 East Adams Street
Upstate University Hospital
Syracuse, NY 13210

Mailing address

750 East Adams Street
Upstate University Hospital
Syracuse, NY 13210
Phone (315) 464-6031

Other identifiers 2

IdentifierTypeStateIssuer
03124494MedicaidNY
0018902490001MedicaidPA

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
I20090929000621 NY Practitioner - Urology 5799762506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Temple University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upstate Urology, Inc.Group PAC ID 1254492952, 24 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 464-6106

550 Harrison St
Suite M
Syracuse, NY 13202-3188
Phone (315) 464-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.32 of 100Reported as group
Quality
89.28
Promoting interoperability
100
Improvement activities
40
Cost
73.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD418317PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Urology, Inc. Urology CurrentSince Jul 3, 2009 Accepting new patients
Reproductive Medicine & Fertility Center Past Accepting new patients
Cny Fertility Center Past Accepting new patients

Locations

4900 Broad Rd
Ste 2I
Syracuse, NY 13215
Phone (315) 464-6106

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: jtrussell7314@direct.upstate.edu

Organizations & group practices 3

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 3

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1245296524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS STREET",
            "address_2": "UPSTATE UNIVERSITY HOSPITAL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-6031",
            "fax_number": "315-464-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS STREET",
            "address_2": "UPSTATE UNIVERSITY HOSPITAL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-6031",
            "fax_number": "315-464-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSSELL",
        "first_name": "J",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD418317",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "253896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03124494",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018902490001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.