Organization Active NPI

Heritage One Day Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • North Syracuse, NY
National Provider Identifier
1295002806
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HERITAGE ONE DAY SURGERY LLC
Practice address
5496 E Taft Rd
Suite B
North Syracuse, NY 13212-3784
Phone
(315) 362-2060
NPI assigned
Nov 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Authorized official

Name
Dr. Robert Tiso, MD
Title
MD/Owner
Phone
(315) 552-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

5496 E Taft Rd
Suite B
North Syracuse, NY 13212-3784

Mailing address

5496 E Taft Rd
Suite B
North Syracuse, NY 13212-3784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120516000604 NY Part B Supplier - Ambulatory Surgical Center 8224291943 Practice locations: North Syracuse, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2037358Heritage One Day Surgery LLC5496 E Taft Road, North Syracuse, NY 13212Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

5496 E Taft Rd
Ste B
Syracuse, NY 13212
Phone (315) 362-2060

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1295002806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "address_2": "SUITE B",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "address_2": "SUITE B",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-362-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE ONE DAY SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "TISO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "315-552-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.