Individual provider Active NPI

Xiwu John Sun, MD

  • Pulmonary Disease Physician
  • Liverpool, NY
National Provider Identifier
1487696241
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
228896 Issued in NY
Practice address
7250 Janus Park Dr
Liverpool, NY 13088-3847
Phone
(315) 475-8402
Fax
(315) 475-0824
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 228896 NY Primary

Addresses

Primary practice location

7250 Janus Park Dr
Liverpool, NY 13088-3847

Mailing address

7250 Janus Park Dr
Liverpool, NY 13088-3847
Phone (315) 475-8402

Other identifiers 1

IdentifierTypeStateIssuer
02660382MedicaidNY

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
I20060822000227 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3072516681 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

7250 Janus Park Dr
Liverpool, NY 13088-4839
Phone (315) 475-8402

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center CurrentSince Aug 1, 2006 Accepting new patients
St. Joseph'S Physician Health, P.C. CurrentSince Jan 5, 2012 Accepting new patients
St. Joseph'S Pathology, PC Current Accepting new patients
St Josephs Medical PC CurrentSince Mar 1, 2020 Accepting new patients
St Joseph'S Hospital Health Center CurrentSince Aug 1, 2006 Accepting new patients

Locations

7250 Janus Park Dr
Liverpool, NY 13088
Phone (315) 475-8402

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

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

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

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

Interoperability endpoints

  • Direct secure messaging: xsun2385638@direct.trinity-health.org

Organizations & group practices 6

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 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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1487696241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 JANUS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883847",
            "telephone_number": "315-475-8402",
            "fax_number": "315-475-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 JANUS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883847",
            "telephone_number": "315-475-8402",
            "fax_number": "315-475-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "XIWU JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "228896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02660382",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.