Individual provider Active NPI

George Mtanos, MD

  • Rheumatology Physician
  • Syracuse, NY
National Provider Identifier
1457326126
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
206080 Issued in NY
Practice address
5794 Widewaters Pkwy
Syracuse, NY 13214-1845
Phone
(315) 422-1513
Fax
(315) 422-5890
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 206080 NY Primary

Addresses

Primary practice location

5794 Widewaters Pkwy
Syracuse, NY 13214-1845

Mailing address

5794 Widewaters Pkwy
Syracuse, NY 13214-1845
Phone (315) 422-1513

Other identifiers 1

IdentifierTypeStateIssuer
01624973MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address george.mtanos@direct.ahasyr.nextgenshare.com

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
I20040719001507 NY Practitioner - Rheumatology 8325027691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arthritis Health Associates PLLCGroup PAC ID 2769461045, 5 clinicians

Practice addresses (Care Compare)

5794 Widewaters Pkwy
Syracuse, NY 13214-1845
Phone (315) 475-7669

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as group
Quality
94.62
Improvement activities
40
Cost
81.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206080NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis Health Associates, PLLC Rheumatology CurrentSince Sep 6, 2004 Accepting new patients

Locations

5794 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 422-1513

Interoperability endpoints

  • Direct secure messaging: george.mtanos@direct.ahasyr.nextgenshare.com

Organizations & group practices 1

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1457326126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5794 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141845",
            "telephone_number": "315-422-1513",
            "fax_number": "315-422-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5794 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141845",
            "telephone_number": "315-422-1513",
            "fax_number": "315-422-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MTANOS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "206080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01624973",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "george.mtanos@direct.ahasyr.nextgenshare.com",
            "affiliation": "N",
            "address_1": "5794 Widewaters Pkwy",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132141845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.