Individual provider Active NPI

Glenn B. Axelrod, M.D.

  • Orthopaedic Surgery Physician
  • Liverpool, NY
National Provider Identifier
1306801501
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
137145 Issued in NY
Practice address
5100 W Taft Rd
Liverpool, NY 13088-3807
Phone
(315) 452-2120
Fax
(315) 452-2118
NPI assigned
Apr 19, 2006
Last updated
Apr 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 137145 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Liverpool, NY 13088-3807

Mailing address

5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone (315) 251-3100

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
I20100126000439 NY Practitioner - Orthopedic Surgery 6800938044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Rochester School of Medicine and Dentistry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC Orthopaedic Surgery CurrentSince May 14, 2002 Accepting new patients

Locations

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1306801501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2120",
            "fax_number": "315-452-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELROD",
        "first_name": "GLENN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "137145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.