Upstate Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

UPSTATE MEDICAL CENTER

Practice address

750 E Adams St
Syracuse, NY 13210-2342

Phone

(315) 464-5654

NPI assigned

Feb 9, 2011

Last updated

Feb 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Immarri Hickman, CRNA

Title

Nurse Anesthetist

Phone

(917) 579-8187

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1386940252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7I CREEKSIDE VLG",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142610040",
            "telephone_number": "917-579-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "IMMARRI",
        "authorized_official_title_or_position": "NURSE ANESTHETIST",
        "authorized_official_telephone_number": "917-579-8187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upstate Community Medical, PC
• Upstate Emergency Medicine, Inc
• Upstate Family and Preventive Medicine, Inc
• Upstate Gastroenterology, LLC
• Upstate Medical Anesthesiology Group, Inc.
• Upstate Medical Professionals, PC
• Upstate Medical University
• Upstate Medical University
• Upstate Medical University
• Upstate Neurosurgery LLP

• General Acute Care Hospital in Syracuse, NY
• Providers in Syracuse, NY by specialty
• General Acute Care Hospital in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.