Syracuse Professional Medical Services of New York LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SYRACUSE PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC

Practice address

1101 Erie Blvd E Ste 201a
Syracuse, NY 13210-1144

Phone

(847) 593-8460

NPI assigned

Feb 13, 2020

Organization subpart

No

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

Authorized official

Name

Yan Katsnelson, MD

Title

Ceo / President

Phone

(847) 593-8460

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Syed Ali Raza Rizvi, DO

  • Vascular Surgery Physician
  • New York, NY
  • NPI 1578882916
  NPD (past)
• David Profit Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1699035923
  NPD (past)

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1487287975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650032",
            "telephone_number": "224-318-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ERIE BLVD E STE 201A",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101144",
            "telephone_number": "847-593-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRACUSE PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "CEO / PRESIDENT",
        "authorized_official_telephone_number": "847-593-8460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syracuse Orthopedic Specialists, PLLC
• Syracuse Orthopedic Specialists, PLLC
• Syracuse Otolaryngology PLLC
• Syracuse Physical Therapy PC
• Syracuse Plastic Surgery, PLLC
• Syracuse Prosthetic Center
• Syracuse Psychological Services PC
• Syracuse Recovery Services
• Syracuse University
• Syracuse University

• Vascular Surgery Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.