NPIMap

Organization Active NPI

Upstate ENT, PLLC

  • Otolaryngology Physician
  • Cortland, NY
National Provider Identifier
1427169655
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
179356 Issued in NY
Legal business name
UPSTATE ENT, PLLC
Practice address
1095 Commons Ave
Cortland, NY 13045-1669
Phone
(607) 756-8075
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Pierre T Martin, MD
Title
Owner
Phone
(607) 756-8075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 179356 NY Primary

Addresses

Primary practice location

1095 Commons Ave
Cortland, NY 13045-1669

Mailing address

1095 Commons Ave
Cortland, NY 13045-1669
Phone (607) 756-8075

Other identifiers 1

IdentifierTypeStateIssuer
01478293MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Upstate ENT PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427169655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 COMMONS AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451669",
            "telephone_number": "607-756-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 COMMONS AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451669",
            "telephone_number": "607-756-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE ENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "PIERRE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-756-8075",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "179356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01478293",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.