Organization Active NPI

Medical Pain Management of Cny, PC

  • Pain Medicine (Anesthesiology) Physician
  • Syracuse, NY
National Provider Identifier
1467632182
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
206367 Issued in NY
Legal business name
MEDICAL PAIN MANAGEMENT OF CNY, PC
Practice address
910 Erie Blvd E
Syracuse, NY 13210-1060
Phone
(315) 423-4315
Fax
(315) 471-6336
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
James M Kowalczyk, M.D.
Title
President
Phone
(315) 471-5888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 206367 NY Primary

Addresses

Primary practice location

910 Erie Blvd E
Syracuse, NY 13210-1060

Mailing address

1001 James St Ste 1
Syracuse, NY 13203-2707
Phone (315) 471-5888

Other identifiers 1

IdentifierTypeStateIssuer
01830175MedicaidNY

National Provider Directory

National Provider Directory

Locations

1001 James St
Ste 1
Syracuse, NY 13203
Phone (315) 471-5888

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1467632182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST STE 1",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032707",
            "telephone_number": "315-471-5888",
            "fax_number": "315-471-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101060",
            "telephone_number": "315-423-4315",
            "fax_number": "315-471-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PAIN MANAGEMENT OF CNY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-471-5888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "206367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01830175",
            "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 Nov 9, 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.