Individual provider Active NPI

David Oommen Joseph, M.D.

  • Critical Care Medicine (Anesthesiology) Physician
  • Syracuse, NY
National Provider Identifier
1467657122
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
250530 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 448-5111
NPI assigned
Jun 20, 2007
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 250530 NY
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 250530 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

Other practice location 1

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-5011

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
I20160226000156 NY Practitioner - Anesthesiology 6800068370 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agcny Physicians PLLCGroup PAC ID 4284804345, 36 clinicians
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

260 Township Blvd
Suite 20
Camillus, NY 13031-1678
Phone (315) 708-0091

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 255-0606

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Agcny Physicians PLLC Anesthesiology CurrentSince Jun 1, 2019 Accepting new patients
Auburn Community Hospital CurrentSince Feb 1, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Feb 1, 2022 Accepting new patients
Auburn Community Hospital CurrentSince Feb 1, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Feb 1, 2022 Accepting new patients
Chag Anesthesia PC Anesthesiology CurrentSince Jun 1, 2019 Accepting new patients
Upstate Medical Anesthesiology Group, Inc. CurrentSince Feb 1, 2016 Accepting new patients
St Josephs Medical PC CurrentSince Jun 1, 2019 Accepting new patients
North Medical PC Current Accepting new patients
Syracuse Endoscopy Associates, LLC PastSince Jul 21, 2024 Accepting new patients
Syracuse Gastroenterological Associates.PC Past Accepting new patients

Locations

17 Lansing St
Ste 302
Auburn, NY 13021
Phone (315) 567-0540

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

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

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

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

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

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

4900 Broad Rd
Ste 2D
Syracuse, NY 13215
Phone (315) 255-0606

5784 Widewaters Pkwy
Ste 2
Syracuse, NY 13214
Phone (315) 469-1134

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 11

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 3

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1467657122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Broad Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132152265",
            "country_code": "US",
            "telephone_number": "315-492-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DAVID",
        "middle_name": "OOMMEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "250530",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NY",
            "license": "250530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.