Individual provider Active NPI

Tamer Ahmed, M.D.

  • Pediatric Surgery Physician
  • Syracuse, NY
National Provider Identifier
1407060866
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
258711 Issued in NY
Practice address
725 Irving Ave
Suite 401
Syracuse, NY 13210-1603
Phone
(315) 464-2878
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 258711 NY Primary

Addresses

Primary practice location

725 Irving Ave
Suite 401
Syracuse, NY 13210-1603

Mailing address

725 Irving Ave
Suite 401
Syracuse, NY 13210-1603
Phone (315) 464-2878

Other identifiers 1

IdentifierTypeStateIssuer
03267085MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SD, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20101214000371 NY Practitioner - General Surgery 1254528490 Reassigns benefits to 1 organization
I20210303002377 SD Practitioner - General SurgeryPractitioner - Pediatric Medicine 1254528490 Reassigns benefits to 1 organization
I20220811001085 PA Practitioner - General Surgery 1254528490 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Avera McKennan CurrentSince Nov 13, 2020 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Jul 1, 2022 Accepting new patients
University Surgical Associates, LLP Pediatric Surgery CurrentSince Sep 19, 2010 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Nov 13, 2020 Accepting new patients
St. Luke'S Physician Group Inc Pediatric Surgery CurrentSince Jul 1, 2022 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

725 Irving Ave
Ste 401
Syracuse, NY 13210
Phone (315) 464-2878

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

701 Ostrum St
Ste 102
Fountain Hill, PA 18015
Phone (484) 526-7575

Interoperability endpoints

  • Direct secure messaging: tamer.ahmed@avera.sdhealthlink.net
  • Direct secure messaging: tahmed10666@direct.upstate.edu

Organizations & group practices 8

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1407060866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "SUITE 401",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "SUITE 401",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "TAMER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "258711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03267085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.