Individual provider Active NPI

Stephen Mark Cohen, M.D.

  • Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1275535734
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
209563-1 Issued in NY
Practice address
739 Irving Ave
Suite 530
Syracuse, NY 13210-1651
Phone
(315) 478-1158
Fax
(315) 478-3014
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 209563-1 NY Primary

Addresses

Primary practice location

739 Irving Ave
Suite 530
Syracuse, NY 13210-1651

Mailing address

739 Irving Ave
Suite 530
Syracuse, NY 13210-1651
Phone (315) 478-1158

Other identifiers 1

IdentifierTypeStateIssuer
01872504MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209563-1NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The New York and Presbyterian Hospital Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1275535734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 530",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101651",
            "telephone_number": "315-478-1158",
            "fax_number": "315-478-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 530",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101651",
            "telephone_number": "315-478-1158",
            "fax_number": "315-478-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "STEPHEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "209563-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01872504",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.