Individual provider Active NPI

James P Riccelli, PT., ECS, CERT MDT

  • Clinical Electrophysiology Physical Therapist
  • E Syracuse, NY
National Provider Identifier
1417927682
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
License
009034-1 Issued in NY
Practice address
4939 Brittonfield Pkwy
E Syracuse, NY 13057-9208
Phone
(315) 234-7322
Fax
(315) 634-3264
NPI assigned
Jan 23, 2006
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0090341 NY
Clinical Electrophysiology Physical Therapist 2251E1300X 009034-1 NY Primary

Addresses

Primary practice location

4939 Brittonfield Pkwy
E Syracuse, NY 13057-9208

Mailing address

4939 Brittonfield Parkway
Suite 103
E. Syracuse, NY 13057
Phone (315) 234-7322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000324 NY Practitioner - Physical Therapist in Private Practice 0840247573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians
Kudos Medical PLLCGroup PAC ID 4183962616, 5 clinicians

Practice addresses (Care Compare)

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488

182 Intrepid LN
Syracuse, NY 13205-2545
Phone (315) 218-7020

308 W Seneca St
Manlius, NY 13104-2318
Phone (315) 682-5232

3709 Erie Blvd E
De Witt, NY 13214-2227
Phone (315) 251-2244

3922 Fennell St
Skaneateles, NY 13152-9316
Phone (315) 685-0908

436 Hinsdale Rd
Camillus, NY 13031-1648
Phone (315) 488-0996

4820 W Taft Rd
Suite 108
Liverpool, NY 13088-4865
Phone (315) 413-0004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009034NYMDRegistered Dietitian
0090341NYMDSpecialist
009034-1NYMDClinical Electrophysiology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC CurrentSince Apr 12, 2003 Accepting new patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Aug 13, 2009 Accepting new patients
Kudos Medical PLLC CurrentSince Sep 28, 2024 Accepting new patients
New York Pain Medicine Associates PC Past Accepting new patients
Kuss Physical Therapy PLLC Electrophysiology, Clinical PastSince Aug 25, 2004 Accepting new patients
Physical Therapy & Electrophysiologic Specialist of Ny PLLC Electrophysiology, Clinical Past Accepting new patients
Chittenango Medical & Wellness Assoc PC PastSince Sep 28, 2024 Accepting new patients

Locations

436 Hinsdale Rd
Camillus, NY 13031
Phone (315) 488-0996

304 Genesee St
Chittenango, NY 13037
Phone (315) 687-6467

5100 W Taft Rd
Ste 2K
Liverpool, NY 13088
Phone (315) 452-2200

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

3709 Erie Blvd E
Syracuse, NY 13214
Phone (315) 251-2244

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1417927682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PARKWAY",
            "address_2": "SUITE 103",
            "city": "E. SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-234-7322",
            "fax_number": "315-634-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "city": "E SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-234-7322",
            "fax_number": "315-634-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCELLI",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "PT., ECS, CERT MDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0090341",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "NY",
            "license": "009034-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.