Individual provider Active NPI

Fadi Nicola Makhlouf, M.D.

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1497918890
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
248976 Issued in NY
Practice address
770 James St
Suite 100
Syracuse, NY 13203-2117
Phone
(315) 422-2222
Fax
(315) 472-8497
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 248976 NY Primary

Addresses

Primary practice location

770 James St
Suite 100
Syracuse, NY 13203-2117

Mailing address

792 N Main St
Suite 100a
North Syracuse, NY 13212-1644
Phone (315) 423-9722

Other identifiers 1

IdentifierTypeStateIssuer
03015703MedicaidNY

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
I20081121000240 NY Practitioner - Obstetrics/Gynecology 8527128479 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-2520

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Associates of Ithaca, LLP Obstetrics & Gynecology CurrentSince Aug 1, 2008 Accepting new patients
St Joseph'S Hospital Health Center Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
North Medical PC Obstetrics & Gynecology Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Jan 1, 2020 Accepting new patients
St Josephs Medical PC CurrentSince May 1, 2020 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients
Rochester General Hospital PastSince Apr 1, 2015 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: fmakhlouf28000@direct.upstate.edu

Organizations & group practices 8

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1497918890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "SUITE 100A",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-423-9722",
            "fax_number": "315-423-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 JAMES ST",
            "address_2": "SUITE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032117",
            "telephone_number": "315-422-2222",
            "fax_number": "315-472-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHLOUF",
        "first_name": "FADI",
        "middle_name": "NICOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "248976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03015703",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.