Individual provider Active NPI

Robert S Nolan, MD

  • Orthopaedic Surgery Physician
  • Liverpool, NY
National Provider Identifier
1497720676
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
235018 Issued in NY
Practice address
5100 W Taft Rd Ste 2T
Liverpool, NY 13088-4841
Phone
(315) 744-1592
Fax
(315) 744-1961
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 235018 NY Primary

Addresses

Primary practice location

5100 W Taft Rd Ste 2T
Liverpool, NY 13088-4841

Mailing address

5100 W Taft Rd Ste 2T
Liverpool, NY 13088-4841
Phone (315) 744-1592

Other practice location 1

104 Union Ave
Ste. 908
Syracuse, NY 13203-1843
Phone (315) 425-0860

Other identifiers 1

IdentifierTypeStateIssuer
02658111MedicaidNY

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
I20050627000535 NY Practitioner - Orthopedic SurgeryPractitioner - Neurosurgery 2769427178 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Neurosurgery
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

77 Nelson St
Suite 120
Auburn, NY 13021-1941
Phone (315) 252-7559

Hospital & facility affiliations

  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion57
Laminectomy or laminotomy (partial removal of spine bones)33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince May 1, 2023 Accepting new patients
Upstate Neurosurgery LLP CurrentSince Nov 1, 2012 Accepting new patients
Auburn Community Hospital CurrentSince May 1, 2023 Accepting new patients
St Josephs Medical PC Orthopaedic Surgery CurrentSince Jan 12, 2019 Accepting new patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince May 1, 2023 Accepting new patients
Neurosurgical Associates of Central New York, LLP CurrentSince Nov 1, 2012 Accepting new patients
North Medical PC Orthopaedic Surgery CurrentSince Jan 12, 2019 Accepting new patients
Auburn Community Hospital CurrentSince May 1, 2023 Accepting new patients
Cny North Urgent Care PLLC Past Accepting new patients

Locations

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

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

5100 W Taft Rd
Ste 4F
Liverpool, NY 13088
Phone (315) 234-9171

5100 W Taft Rd
Ste 1D
Liverpool, NY 13088
Phone (315) 452-2828

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

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470

104 Union Ave
Ste 908
Syracuse, NY 13203
Phone (315) 425-0860

Interoperability endpoints

  • Direct secure messaging: drrnolan@amms.medentdirect.com

Organizations & group practices 9

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 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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1497720676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 2T",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884841",
            "telephone_number": "315-744-1592",
            "fax_number": "315-744-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 2T",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884841",
            "telephone_number": "315-744-1592",
            "fax_number": "315-744-1961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Union Ave",
            "address_2": "Ste. 908",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132031843",
            "country_code": "US",
            "telephone_number": "315-425-0860",
            "fax_number": "315-425-0854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "ROBERT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "235018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02658111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.