Active NPI
Paul Kronenberg, M.D.
- Internal Medicine Physician
- Syracuse, NY
National Provider Identifier
1336143783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 107062
- Practice address
- 739 Irving Ave
Ste 200
Syracuse, NY 13210-1668 - Phone
- (315) 479-5070
- Fax
- (315) 701-2520
- NPI assigned
- Jun 13, 2005
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 107062 | NY | Primary |
Addresses
Primary practice location
739 Irving Ave
Ste 200
Syracuse, NY 13210-1668
Mailing address
739 Irving Ave
Ste 200
Syracuse, NY 13210-1668
Phone (315) 479-5070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00559999 | Medicaid | NY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1336143783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "739 IRVING AVE",
"address_2": "STE 200",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101668",
"telephone_number": "315-479-5070",
"fax_number": "315-701-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "739 IRVING AVE",
"address_2": "STE 200",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101668",
"telephone_number": "315-479-5070",
"fax_number": "315-701-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRONENBERG",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "107062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00559999",
"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 Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.