Individual provider Active NPI

Clifford B Soults, MD

  • Neurological Surgery Physician
  • Syracuse, NY
National Provider Identifier
1508858572
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
218599 Issued in NY
Practice address
739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Phone
(315) 701-2550
Fax
(315) 701-2551
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 218599 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 600
Syracuse, NY 13210-1663

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 701-2550

Other practice location 1

86 Genesee St
Ste 304
New Hartford, NY 13413-2389
Phone (315) 792-7629

Other identifiers 1

IdentifierTypeStateIssuer
02107808MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csoultz@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

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
I20091008000318 NY Practitioner - Neurosurgery 2769528561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

739 Irving Ave
Suite 600
Syracuse, NY 13210-1663
Phone (315) 701-2550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion67
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice PLLC CurrentSince Apr 1, 2017 Accepting new patients
Crouse Medical Practice, PLLC Neurological Surgery CurrentSince Apr 1, 2017 Accepting new patients
Crouse Health Hospital, Inc. Past Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

555 French Rd
Bldg 2
New Hartford, NY 13413
Phone (315) 701-2550

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

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

739 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 471-0190

Interoperability endpoints

  • Direct secure messaging: csoults@crousemed.medentdirect.com
  • Direct secure messaging: csoultz@crousemed.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1508858572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-701-2550",
            "fax_number": "315-701-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101663",
            "telephone_number": "315-701-2550",
            "fax_number": "315-701-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Genesee St",
            "address_2": "Ste 304",
            "address_purpose": "LOCATION",
            "city": "New Hartford",
            "state": "NY",
            "postal_code": "134132389",
            "country_code": "US",
            "telephone_number": "315-792-7629",
            "fax_number": "315-792-3617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOULTS",
        "first_name": "CLIFFORD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "218599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02107808",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csoultz@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 600",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.