Organization Active NPI

Ithaca Urology PLLC

  • Urology Physician
  • Ithaca, NY
National Provider Identifier
1427009802
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ITHACA UROLOGY PLLC
Practice address
1301 Trumansburg Road
Suite M
Ithaca, NY 14850
Phone
(607) 273-8502
Fax
(607) 273-6115
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Dr. Sami Husseini, MDNPI 1871563577
Title
Owner/Physician
Phone
(607) 273-8502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1301 Trumansburg Road
Suite M
Ithaca, NY 14850

Mailing address

202 Taughannock Blvd
PO Box 366
Ithaca, NY 14851
Phone (607) 277-3257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000190 NY Part B Supplier - Clinic/Group Practice 7012172547 Receives reassigned benefits from 2 practitioners
Practice locations: Ithaca, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0676968Ithaca Urology PC1301 Trumansburg Road, Ithaca, NY 14850Provider-performed microscopyMar 31, 2028

National Provider Directory

National Provider Directory

Locations

1301 Trumansburg Rd
Ste M
Ithaca, NY 14850
Phone (607) 273-8502

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1427009802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 TAUGHANNOCK BLVD",
            "address_2": "PO BOX 366",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14851",
            "telephone_number": "607-277-3257",
            "fax_number": "607-277-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TRUMANSBURG ROAD",
            "address_2": "SUITE M",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-273-8502",
            "fax_number": "607-273-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITHACA UROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "HUSSEINI",
        "authorized_official_first_name": "SAMI",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "607-273-8502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.