NPIMap

Organization Active NPI

Department of Medicine MSG

  • Internal Medicine Physician
  • Syracuse, NY
National Provider Identifier
1396765632
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DEPARTMENT OF MEDICINE MSG
Practice address
550 Harrison St
Suite 200
Syracuse, NY 13202-3096
Phone
(315) 464-6527
Fax
(315) 464-6529
NPI assigned
Jul 20, 2006
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
Michael C. Iannuzzi, MD
Title
President
Phone
(315) 464-4505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X NY

Addresses

Primary practice location

550 Harrison St
Suite 200
Syracuse, NY 13202-3096

Mailing address

550 Harrison St
Suite 200
Syracuse, NY 13202-3096
Phone (315) 464-6527

Other identifiers 1

IdentifierTypeStateIssuer
00459903MedicaidNY

Other names 1

  • University Internists/Hospitalists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Department of Medicine MSG6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

550 Harrison St
Ste 200
Syracuse, NY 13202
Phone (315) 464-6527

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1396765632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HARRISON ST",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023096",
            "telephone_number": "315-464-6527",
            "fax_number": "315-464-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HARRISON ST",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023096",
            "telephone_number": "315-464-6527",
            "fax_number": "315-464-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MEDICINE MSG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "IANNUZZI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-464-4505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Internists/Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.