Individual provider Active NPI

Scott M Reizun, MD

  • Anesthesiology Physician
  • Syracuse, NY
National Provider Identifier
1366446262
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
173287 Issued in NY
Practice address
4900 Broad Rd
Syracuse, NY 13215-2265
Phone
(315) 492-5522
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 173287 NY
Anesthesiology Physician 207L00000X 173287 NY Primary

Addresses

Primary practice location

4900 Broad Rd
Syracuse, NY 13215-2265

Mailing address

PO Box 2005
East Syracuse, NY 13057-4505
Phone (315) 449-0513

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
I20041014000759 NY Practitioner - Anesthesiology 0648169961 Reassigns benefits to 3 organizations
Practice locations: Cortland, NY; Utica, NY; Syracuse, NY; Schenectady, NY; Oneida, NY; Liverpool, NY; Geneva, NY; Fulton, NY…

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of Ny Upstate Medical University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

4302 Medical Ctr Dr
Suite 302
Fayetteville, NY 13066-6625
Phone (315) 423-9722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173287NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chag Anesthesia PC Anesthesiology CurrentSince Jan 2, 2002 Accepting new patients
Syracuse ASC LLC Anesthesiology CurrentSince Mar 1, 2025 Accepting new patients
Agcny Physicians PLLC Anesthesiology CurrentSince Oct 5, 2011 Accepting new patients
Urology Specialists of Cny, PC Past Accepting new patients
Upstate Medical Anesthesiology Group, Inc. Past Accepting new patients
Fulton Family Psychiatry PC PastSince May 14, 2019 Accepting new patients
Oswego County Urology PC Past Accepting new patients
RJ Anesthesia PLLC Anesthesiology PastSince Nov 18, 2025 Accepting new patients
Cny Facial Surgery Group, PC PastSince Jul 8, 2014 Accepting new patients

Locations

4939 Brittonfield Pkwy
Ste 210
East Syracuse, NY 13057
Phone (315) 471-2713

4939 Brittonfield Pkwy
Ofc 1
East Syracuse, NY 13057
Phone (315) 471-8404

4302 Medical Center Dr
#302
Fayetteville, NY 13066
Phone (315) 423-9722

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

225 Greenfield Pkwy
Ste 105
Liverpool, NY 13088
Phone (315) 451-6911

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

190 Intrepid Ln
#One
Syracuse, NY 13205
Phone (315) 498-6200

195 Intrepid Ln
Syracuse, NY 13205
Phone (315) 469-6789

4900 Broad Rd
Bldg S
Syracuse, NY 13215
Phone (315) 299-5313

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

1000 E Genesee St
Ste 500
Syracuse, NY 13210
Phone (315) 471-2713

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Organizations & group practices 9

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589587200000",
    "number": "1366446262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574505",
            "telephone_number": "315-449-0513",
            "fax_number": "315-445-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIZUN",
        "first_name": "SCOTT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "173287",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "173287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.