Individual provider Active NPI

Matthew L Dalton, MD

  • Anesthesiology Physician
  • Syracuse, NY
National Provider Identifier
1447254156
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
177777 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7828
Fax
(315) 470-5811
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 177777 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

PO Box 2005
East Syracuse, NY 13057-4505
Phone (315) 449-0513

Other identifiers 1

IdentifierTypeStateIssuer
01131153MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110106000991 NY Practitioner - Anesthesiology 8224926712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffiss Ec, LLCGroup PAC ID 8628249521, 14 clinicians

Practice addresses (Care Compare)

105 Dart Cir
Rome, NY 13441-4229
Phone (315) 533-5747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177777NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Mar 11, 2021 Accepting new patients
Chag Anesthesia PC Anesthesiology CurrentSince Feb 1, 2024 Accepting new patients
Agcny Physicians PLLC Anesthesiology CurrentSince Feb 1, 2024 Accepting new patients
Griffiss Ec, LLC Anesthesiology CurrentSince Oct 18, 2021 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

260 Township Blvd
Ste 20
Camillus, NY 13031
Phone (315) 708-0091

5000 Brittonfield Pkwy
Ste A128
East Syracuse, NY 13057
Phone (315) 446-4400

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

105 Dart Cir
Rome, NY 13441
Phone (315) 334-6918

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

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

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 4

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1447254156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574505",
            "telephone_number": "315-449-0513",
            "fax_number": "315-445-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7828",
            "fax_number": "315-470-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "177777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01131153",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.