Individual provider Active NPI

Phillip John Gary, MD

  • Pulmonary Disease Physician
  • Syracuse, NY
National Provider Identifier
1548623002
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
312739 Issued in NY
Practice address
90 Presidential Plaza
2ND FL
Syracuse, NY 13202
Phone
(315) 464-3835
Fax
(315) 464-3837
NPI assigned
Apr 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 321739 NY
Pulmonary Disease Physician 207RP1001X 67353 MN
Pulmonary Disease Physician 207RP1001X 312739 NY Primary

Addresses

Primary practice location

90 Presidential Plaza
2ND FL
Syracuse, NY 13202

Mailing address

90 Presidential Plaza
2ND FL
Syracuse, NY 13202
Phone (315) 464-3835

Other practice location 1

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 276-2000

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
I20230605002404 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 6406144096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

17 Lansing St
Auburn, NY 13021-1983

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-5678

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4457

77 Nelson St
Auburn, NY 13021-1941

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67353MNMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Auburn Community Hospital CurrentSince Jan 1, 2025 Accepting new patients
Auburn Memorial Medical Services, PC Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Jul 1, 2023 Accepting new patients
Upstate Community Medical, PC CurrentSince Aug 6, 2023 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jan 1, 2025 Accepting new patients
Auburn Community Hospital Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

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

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

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

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

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

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

90 Presidential Plz
Fl 2
Syracuse, NY 13202
Phone (315) 464-3833

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

Interoperability endpoints

  • Direct secure messaging: pgary144245@direct.upstate.edu
  • Direct secure messaging: pgary@amms.medentdirect.com

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 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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1548623002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLAZA",
            "address_2": "2ND FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-464-3835",
            "fax_number": "315-464-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLAZA",
            "address_2": "2ND FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-464-3835",
            "fax_number": "315-464-3837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "484-276-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARY",
        "first_name": "PHILLIP",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "321739",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "67353",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "312739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.