Individual provider Active NPI

Gerard McCrohan, M.D.

  • Diagnostic Radiology Physician
  • Syracuse, NY
National Provider Identifier
1316924020
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
202020 Issued in NY
Practice address
1000 E Genesee St
Suite 100
Syracuse, NY 13210-1892
Phone
(315) 472-8835
Fax
(315) 476-3712
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 202020-1 NY
Diagnostic Radiology Physician 2085R0202X 202020 NY Primary

Addresses

Primary practice location

1000 E Genesee St
Suite 100
Syracuse, NY 13210-1892

Mailing address

1000 E Genesee St
Suite 100
Syracuse, NY 13210-1892
Phone (315) 269-9729

Other identifiers 1

IdentifierTypeStateIssuer
01692502MedicaidNY

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
I20090619000578 NY Practitioner - Diagnostic Radiology 7416008180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cny Diagnostic Imaging AssociatesGroup PAC ID 3072564244, 5 clinicians

Practice addresses (Care Compare)

8100 Oswego Rd
Suite 100
Liverpool, NY 13090-1600
Phone (315) 652-1020

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202020-1NYMDSpecialist
202020NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Diagnostic Imaging Associates Specialist CurrentSince Apr 1, 1996 Accepting new patients
Crouse Medical Practice, PLLC PastSince Apr 1, 1996 Accepting new patients

Locations

8100 Oswego Rd
Ste 100
Liverpool, NY 13090
Phone (315) 453-5004

1000 E Genesee St
Ste 100
Syracuse, NY 13210
Phone (315) 269-9729

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1316924020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-269-9729",
            "fax_number": "315-472-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-472-8835",
            "fax_number": "315-476-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCROHAN",
        "first_name": "GERARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "202020-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "202020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01692502",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.