Organization Active NPI

University Surgical Associates, LLP

  • Surgery Physician
  • Syracuse, NY
National Provider Identifier
1376590117
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
UNIVERSITY SURGICAL ASSOCIATES, LLP
Practice address
750 E Adams St
Ste. 8140
Syracuse, NY 13210-2306
Phone
(315) 464-1800
Fax
(315) 464-6252
NPI assigned
May 27, 2006
Last updated
Oct 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Authorized official

Name
Robert N. Cooney, MDNPI 1639136237
Title
Chairman
Phone
(315) 464-9852

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X NU
Internal Medicine Physician 207R00000X NU
Surgery Physician 208600000X NU Primary
Surgical Critical Care Physician 2086S0102X NU
Pediatric Surgery Physician 2086S0120X NU
Plastic and Reconstructive Surgery Physician 2086S0122X NU
Trauma Surgery Physician 2086S0127X NU
Vascular Surgery Physician 2086S0129X NU
Colon & Rectal Surgery Physician 208C00000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

750 E Adams St
Ste. 8140
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Ste. 8140
Syracuse, NY 13210-2306
Phone (315) 464-1800

Other identifiers 1

IdentifierTypeStateIssuer
01591120MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000499 NY Part B Supplier - Clinic/Group Practice 7315834165 Receives reassigned benefits from 125 practitioners
Practice locations: Syracuse, NY; Watertown, NY; Ogdensburg, NY; Ithaca, NY; Hamilton, NY; Fayetteville, NY; Camillus, NY; Oswego, NY

National Provider Directory

National Provider Directory

Locations

1301 Trumansburg Rd
Ste E
Ithaca, NY 14850
Phone (607) 273-1101

140 W 6th St
Ste 170
Oswego, NY 13126
Phone (315) 464-6264

104 Union Ave
Ste 804
Syracuse, NY 13203
Phone (315) 703-5049

4900 Broad Rd
Ste 2B
Syracuse, NY 13215
Phone (315) 492-5036

4900 Broad Rd
Ste 3K
Syracuse, NY 13215
Phone (315) 492-5750

505 Irving Ave
Ste 1249B
Syracuse, NY 13210
Phone (315) 464-9852

550 Harrison St
Ste 120
Syracuse, NY 13202
Phone (315) 464-8224

725 Irving Ave
Ste 211
Syracuse, NY 13210
Phone (315) 464-5533

750 E Adams St
Ste 2W
Syracuse, NY 13210
Phone (315) 464-9535

750 E Adams St
Ste 4835
Syracuse, NY 13210
Phone (315) 464-1800

750 E Adams St
Ste 8140
Syracuse, NY 13210
Phone (315) 464-1800

1571 Washington St
Ste 103
Watertown, NY 13601
Phone (315) 464-6264

Practitioners & affiliated clinicians

Practitioners 216

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 216

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1376590117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "STE. 8140",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-1800",
            "fax_number": "315-464-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "STE. 8140",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-1800",
            "fax_number": "315-464-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SURGICAL ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "COONEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "315-464-9852",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01591120",
            "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 Oct 13, 2010; 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.