Imad S Nsouli, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

148367-1 Issued in NY

Practice address

800 Irving Ave
Syracuse, NY 13210-2716

Phone

(315) 425-2636

Fax

(315) 425-2639

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Upstate Urology, Inc.

  • Urology Physician
  • Syracuse, NY
  • NPI 1003062043
  Medicare reassignment NPD

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1396780243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-2636",
            "fax_number": "315-425-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-2636",
            "fax_number": "315-425-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSOULI",
        "first_name": "IMAD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "148367-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02891427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Day Novakowski, RN
• Alice Nowark, LMFT
• Colleen Elizabeth Nowell, FNP
• Debra Ann Nowicki, OTR/L
• Patricia Esther Nsamba Buzangu Mbaya, MD
• Tamara Nsouli
• Isaac Ntansah-Boateng
• Rey David Nuez Lopez, MD
• Megan Nugent, LMHC
• Kaamel Nuhu, MD

• Urology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.