Active NPI
John A Friedman, M.D.
- Pediatrics Physician
- Syracuse, NY
National Provider Identifier
1306896873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 133572
- Practice address
- 90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240 - Phone
- (315) 464-4357
- Fax
- (315) 464-2030
- NPI assigned
- May 12, 2006
- Last updated
- Jun 24, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 133572 | NY | Primary |
Addresses
Primary practice location
90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Mailing address
90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Phone (315) 464-4357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00821105 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133572 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New York Comptrollers Office | Past | Accepting new patients |
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.
-
- Developmental Disabilities Clinic/Center
- Staten Island, NY
- NPI 1750469912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1306896873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"address_2": "3RD FLOOR",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240",
"telephone_number": "315-464-4357",
"fax_number": "315-464-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"address_2": "3RD FLOOR",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240",
"telephone_number": "315-464-4357",
"fax_number": "315-464-2030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "JOHN",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "133572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00821105",
"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 Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.