Individual provider Active NPI

Jawad N. Kassem, MD

  • Emergency Medicine Physician
  • Syracuse, NY
National Provider Identifier
1417110438
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
255629 Issued in NY
Practice address
750 East Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-4363
Fax
(315) 464-8690
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA08981200 NJ
Emergency Medicine Physician 207P00000X 255629-1 NY
Emergency Medicine Physician 207P00000X MD440753 PA
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X MD440753 PA
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 255629 NY
Emergency Medicine Physician 207P00000X 255629 NY Primary

Addresses

Primary practice location

750 East Adams St
Syracuse, NY 13210-2306

Mailing address

251 Salina Meadows Pkwy
Suite 100
Syracuse, NY 13212-4516
Phone (315) 464-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255629-1NYMDEmergency Medicine Physician
255629NYMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Emergency Medicine Past Accepting new patients
Newton Emo LLC Past Accepting new patients

Organizations & group practices 2

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1417110438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PKWY",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124516",
            "telephone_number": "315-464-2000",
            "fax_number": "315-464-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSEM",
        "first_name": "JAWAD",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA08981200",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "255629-1",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD440753",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "PA",
            "license": "MD440753",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NY",
            "license": "255629",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "255629",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 24, 2019; 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.