NPIMap

Organization Active NPI

Loftus, Ryu & Bartol MD'S PC

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1326041286
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LOFTUS, RYU & BARTOL MD'S PC
Practice address
475 Irving Ave
Ste 108
Syracuse, NY 13210-1691
Phone
(315) 671-0070
Fax
(315) 475-0620
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Marie Ditoma
Title
Practice Manager
Phone
(315) 671-0070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0960021 NY
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

475 Irving Ave
Ste 108
Syracuse, NY 13210-1691

Mailing address

475 Irving Ave
Ste 108
Syracuse, NY 13210-1691
Phone (315) 671-0070

Other identifiers 1

IdentifierTypeStateIssuer
BW9NMedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MEDENT Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070920000664 NY Part B Supplier - Clinic/Group Practice 6901990936 Receives reassigned benefits from 6 practitioners
Practice locations: Syracuse, NY

National Provider Directory

National Provider Directory

Locations

475 Irving Ave
Ste 108
Syracuse, NY 13210
Phone (315) 671-0070

Practitioners & affiliated clinicians

Practitioners 6

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1326041286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "STE 108",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101691",
            "telephone_number": "315-671-0070",
            "fax_number": "315-475-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "STE 108",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101691",
            "telephone_number": "315-671-0070",
            "fax_number": "315-475-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOFTUS, RYU & BARTOL MD'S PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "DITOMA",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "315-671-0070"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "0960021",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BW9N",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MEDENT",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "475 Irving Ave",
            "address_2": "Ste 108",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.