Individual provider Active NPI

Soubhi Azar, M.D.

  • Internal Medicine Physician
  • Manlius, NY
National Provider Identifier
1457646341
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
275660 Issued in NY
Practice address
4500 Pewter LN BLDG 1
Manlius, NY 13104-7704
Phone
(315) 682-6600
Fax
(315) 682-0570
NPI assigned
Jun 20, 2011
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 275660 NY Primary

Addresses

Primary practice location

4500 Pewter LN BLDG 1
Manlius, NY 13104-7704

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

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
I20140813001340 NY Practitioner - Internal Medicine 0648497701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

4500 Pewter LN
Suite 1
Manlius, NY 13104-7704
Phone (315) 682-6600

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-7111

739 Irving Ave
Suite 200
Syracuse, NY 13210-1668
Phone (315) 479-5070

739 Irving Ave
Suite 500
Syracuse, NY 13210-1664
Phone (315) 470-7409

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice PLLC CurrentSince Jul 1, 2014 Accepting new patients
Crouse Medical Practice, PLLC Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

4500 Pewter Ln
Bldg 1
Manlius, NY 13104
Phone (315) 470-7409

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

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

739 Irving Ave
Ste 200
Syracuse, NY 13210
Phone (315) 479-5070

Interoperability endpoints

  • Direct secure messaging: sazar@crousemed.medentdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1457646341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-472-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PEWTER LN BLDG 1",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131047704",
            "telephone_number": "315-682-6600",
            "fax_number": "315-682-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAR",
        "first_name": "SOUBHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "275660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

Verify at the official NPI Registry.