Individual provider Active NPI

Demir Ahmetovic, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1487361945
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
145722 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1602
Phone
(315) 470-7111
NPI assigned
Nov 3, 2022
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 145722 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1602

Mailing address

338 Jamesville Ave Apt 4a
Syracuse, NY 13210-3268
Phone (585) 298-3023

Other practice location 1

110 W 6th St
Oswego, NY 13126-2598
Phone (315) 349-5511

Other practice location 2

5801 E Taft Rd
Syracuse, NY 13212-3291
Phone (315) 418-4140

Other practice location 3

725 Irving Ave
Syracuse, NY 13210-1603
Phone (315) 470-7994

Other practice location 4

475 Irving Ave
Syracuse, NY 13210-1756
Phone (315) 475-8401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222001463 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739559329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia LLPGroup PAC ID 7719885771, 427 clinicians

Practice addresses (Care Compare)

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
145722NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego Hospital CurrentSince Nov 7, 2022 Accepting new patients
U of R Anesthesiology Group CurrentSince Nov 27, 2023 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Apr 2, 2024 Accepting new patients
Oswego Hospital CurrentSince Nov 7, 2022 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1487361945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 JAMESVILLE AVE APT 4A",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103268",
            "telephone_number": "585-298-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101602",
            "telephone_number": "315-470-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W 6th St",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "NY",
            "postal_code": "131262598",
            "country_code": "US",
            "telephone_number": "315-349-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5801 E Taft Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132123291",
            "country_code": "US",
            "telephone_number": "315-418-4140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Irving Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101603",
            "country_code": "US",
            "telephone_number": "315-470-7994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 Irving Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101756",
            "country_code": "US",
            "telephone_number": "315-475-8401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMETOVIC",
        "first_name": "DEMIR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "145722",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.