Individual provider Active NPI

Ernest Loran Sutton, MD

  • Gastroenterology Physician
  • Syracuse, NY
National Provider Identifier
1306957527
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101259170 Issued in VA
Practice address
800 Irving Ave
MSC 111 G
Syracuse, NY 13210-2716
Phone
(412) 897-3405
Fax
(315) 425-2647
NPI assigned
Aug 31, 2006
Last updated
Jan 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036-053364 IL
Gastroenterology Physician 207RG0100X MD431386 PA
Gastroenterology Physician 207RG0100X 35.096129 OH
Gastroenterology Physician 207RG0100X 0101259170 VA Primary

Addresses

Primary practice location

800 Irving Ave
MSC 111 G
Syracuse, NY 13210-2716

Mailing address

800 Irving Ave
MSC 111 G
Syracuse, NY 13210-2716
Phone (412) 897-3405

Other identifiers 3

IdentifierTypeStateIssuer
1019433630001MedicaidPA
2986309MedicaidOH
1019433630002MedicaidPA

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
036-053364ILMDGastroenterology Physician
35.096129OHMDGastroenterology Physician
0101259170VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nasrollah Jahdi, M.D. Gastroenterology Past Accepting new patients
Nasrollah Jahdi MD Inc Gastroenterology 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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1306957527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "address_2": "MSC 111 G",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "412-897-3405",
            "fax_number": "315-425-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "address_2": "MSC 111 G",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "412-897-3405",
            "fax_number": "315-425-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "ERNEST",
        "middle_name": "LORAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-053364",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD431386",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.096129",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101259170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019433630001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2986309",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019433630002",
            "state": "PA"
        }
    ],
    "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 Jan 8, 2016; 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.