Individual provider Active NPI

Amar C Suryadevara, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Syracuse, NY
National Provider Identifier
1255599494
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
251462-1 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2342
Phone
(315) 464-7279
Fax
(315) 464-7282
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 251462-1 NY Primary
Otolaryngology Physician 207Y00000X MD60003283 WA

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2342

Mailing address

750 E Adams St
Syracuse, NY 13210-2342
Phone (315) 464-7279

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
I20090623000397 NY Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9638242142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
State University of Ny Upstate Medical University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

105 County Route 45a
Suite 100
Oswego, NY 13126-6665
Phone (315) 342-6771

4304 Medical Ctr Dr
Fayetteville, NY 13066-6625
Phone (315) 329-7350

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-3741

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4633

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
97.54 of 100Reported as group
Quality
96.28
Promoting interoperability
100
Improvement activities
40
Cost
95.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision45
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60003283WAMDOtolaryngology Physician
251462-1NYMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Associates of Central New York, LLP Otolaryngology CurrentSince Jul 1, 2009 Accepting new patients
Physician Care PC Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: asuryadevara7307@direct.upstate.edu

Organizations & group practices 2

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1255599494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-7279",
            "fax_number": "315-464-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-7279",
            "fax_number": "315-464-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYADEVARA",
        "first_name": "AMAR",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "251462-1",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD60003283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.