Organization Active NPI

Andrew J. Rurka, MD

  • Pediatrics Physician
  • Syracuse, NY
National Provider Identifier
1457499527
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
115546 Issued in NY
Legal business name
ANDREW J. RURKA, MD
Practice address
1200 E Genesee St
Suite 310
Syracuse, NY 13210-1968
Phone
(315) 475-6101
Fax
(315) 475-1827
NPI assigned
Feb 2, 2007
Last updated
Sep 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Authorized official

Name
Dr. Andrew J Rurka, M.D.
Title
Medical Director
Phone
(315) 475-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 115546 NY Primary

Addresses

Primary practice location

1200 E Genesee St
Suite 310
Syracuse, NY 13210-1968

Mailing address

1200 E Genesee St
Suite 310
Syracuse, NY 13210-1968
Phone (315) 475-6101

Other identifiers 1

IdentifierTypeStateIssuer
00547008MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1457499527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E GENESEE ST",
            "address_2": "SUITE 310",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101968",
            "telephone_number": "315-475-6101",
            "fax_number": "315-475-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E GENESEE ST",
            "address_2": "SUITE 310",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101968",
            "telephone_number": "315-475-6101",
            "fax_number": "315-475-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J. RURKA, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "RURKA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "315-475-6101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "115546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00547008",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.