NPIMap

Organization Active NPI

M. Robert Neulander, M.D.

  • Specialist
  • Camillus, NY
National Provider Identifier
1306990692
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
138711 Issued in NY
Legal business name
M. ROBERT NEULANDER, M.D.
Practice address
5700 W Genesee St
Suite 101 North
Camillus, NY 13031-3200
Phone
(315) 488-1112
Fax
(315) 488-6707
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marion Robert Neulander, M.D.
Title
Owner
Phone
(315) 488-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 138711 NY Primary

Addresses

Primary practice location

5700 W Genesee St
Suite 101 North
Camillus, NY 13031-3200

Mailing address

5700 W Genesee St
Suite 101 North
Camillus, NY 13031-3200
Phone (315) 488-1112

Other identifiers 1

IdentifierTypeStateIssuer
00716385MedicaidNY

Other names 1

  • CHOICES WEST Doing business as

National Provider Directory

National Provider Directory

Locations

5700 W Genesee St
Ste 101
Camillus, NY 13031
Phone (315) 488-1112

Practitioners & affiliated clinicians

Practitioners 5

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306990692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "SUITE 101 NORTH",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-1112",
            "fax_number": "315-488-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "SUITE 101 NORTH",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-1112",
            "fax_number": "315-488-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. ROBERT NEULANDER, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEULANDER",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-488-1112",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "138711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00716385",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOICES WEST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.