Individual provider Active NPI

Nicholas Melvin Runeare, MD

  • Internal Medicine Physician
  • Oswego, NY
National Provider Identifier
1508390642
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
304547 Issued in NY
Practice address
110 W 6TH St
Oswego, NY 13126-2598
Phone
(315) 349-5511
NPI assigned
Apr 15, 2017
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 304547 NY Primary

Addresses

Primary practice location

110 W 6TH St
Oswego, NY 13126-2598

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200929003584 NY Practitioner - Internal Medicine 2163769787 Reassigns benefits to 2 organizations
I20241107000868 PA Practitioner - Internal Medicine 2163769787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oswego HospitalGroup PAC ID 4981686045, 59 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

111 S 11TH St
1St FLR Bodine Ctr
Philadelphia, PA 19107-5097
Phone (215) 955-6702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.55 of 100Reported as apm
Quality
83.57
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304547NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Internal Medicine CurrentSince Sep 16, 2024 Accepting new patients
Jefferson University Physicians Internal Medicine CurrentSince Sep 16, 2024 Accepting new patients
Upstate Community Medical, PC CurrentSince Jul 20, 2020 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 16, 2024 Accepting new patients
Oswego Hospital CurrentSince Jul 1, 2021 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

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

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

111 S 11th St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-6702

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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, 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": "1492214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1508390642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262598",
            "telephone_number": "315-349-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262598",
            "telephone_number": "315-349-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNEARE",
        "first_name": "NICHOLAS",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-15",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "304547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.