Individual provider Active NPI

Teriza B Shehatou, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
National Provider Identifier
1477548543
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
236767 Issued in NY
Practice address
736 Irving Ave
9TH Floor
Syracuse, NY 13210-1687
Phone
(315) 470-7396
Fax
(315) 470-2806
NPI assigned
Sep 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 236767 NY Primary

Addresses

Primary practice location

736 Irving Ave
9TH Floor
Syracuse, NY 13210-1687

Mailing address

4567 Crossroads Park Dr
Liverpool, NY 13088-3589
Phone (315) 295-2100

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
I20060629000191 NY Practitioner - Pathology 3476563677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of Syracuse PCGroup PAC ID 3173516804, 5 clinicians

Practice addresses (Care Compare)

736 Irving Ave
FL 9
Syracuse, NY 13210-1687
Phone (315) 470-7396

736 Irving Ave 9TH Floor
Syracuse, NY 13210-1687

739 Irving Ave
Suite 430
Syracuse, NY 13210-1653
Phone (315) 234-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.09 of 100Reported as group
Quality
97.07
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Gastroenterological Associates PC CurrentSince Jun 1, 2017 Accepting new patients
Syracuse Gastroenterological Associates.PC CurrentSince Jun 1, 2017 Accepting new patients
Pathology Associates of Syracuse, PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2005 Accepting new patients
Cytology Associates of Cny PLLC PastSince Jul 1, 2008 Accepting new patients

Locations

150 Broad St
Hamilton, NY 13346
Phone (315) 824-1100

739 Irving Ave
Ste 430
Syracuse, NY 13210

736 Irving Ave
Fl 9
Syracuse, NY 13210
Phone (315) 470-7396

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

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1477548543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "address_2": "9TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7396",
            "fax_number": "315-470-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHATOU",
        "first_name": "TERIZA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "236767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.