Individual provider Active NPI

Nader Estfanous, MD

  • Surgery Physician
  • Syracuse, NY
National Provider Identifier
1275030140
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
333167 Issued in NY
Practice address
750 East Adams St
Syracuse, NY 13210
Phone
(315) 464-1800
Fax
(315) 464-6238
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 333167 NY Primary
Surgery Physician 208600000X 35.147897 OH

Addresses

Primary practice location

750 East Adams St
Syracuse, NY 13210

Mailing address

750 East Adams St
Syracuse, NY 13210
Phone (315) 464-1800

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
I20241025003028 NY Practitioner - General Surgery 0244691889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgical Associates LLPGroup PAC ID 7315834165, 49 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

725 Irving Ave
Suite 401
Syracuse, NY 13210-1684
Phone (315) 464-2878

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333167NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical Associates, LLP Surgery CurrentSince Dec 1, 2024 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

725 Irving Ave
Ste 401
Syracuse, NY 13210
Phone (315) 464-2878

4900 Broad Rd
Ste 2B
Syracuse, NY 13215
Phone (315) 492-5036

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

Interoperability endpoints

  • Direct secure messaging: nestfanous160899@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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1275030140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-1800",
            "fax_number": "315-464-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-1800",
            "fax_number": "315-464-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTFANOUS",
        "first_name": "NADER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-12-10",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "333167",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.147897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.