Active NPI
Aravind Bizwar Reddy, MD
- Neurology Physician
- Syracuse, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 310837
- Practice address
- 750 E Adams St
Syracuse, NY 13210-2306 - Phone
- (315) 464-4243
- NPI assigned
- Jul 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME162860 | FL | |
| Neurology Physician | 2084N0400X | 2023047334 | MO | |
| Neurology Physician | 2084N0400X | 24278 | NV | |
| Neurology Physician | 2084N0400X | 2023-00847 | NC | |
| Neurology Physician | 2084N0400X | 69079 | TN | |
| Neurology Physician | 2084N0400X | 0101279289 | VA | |
| Neurology Physician | 2084N0400X | 98412 | GA | |
| Neurology Physician | 2084N0400X | 310837 | NY | Primary |
| Neurology Physician | 2084N0400X | MD61349471 | WA | |
| Neurology Physician | 2084N0400X | 036169458 | IL | |
| Neurology Physician | 2084N0400X | MD220867 | OR |
Addresses
Primary practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565
Other practice location 1
127 Health Care Dr Ste 3
Pennington Gap, VA 24277-2853
Phone (423) 230-5000
Other practice location 2
6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 248-1300
Other practice location 3
100 15th St NW
Norton, VA 24273-1616
Phone (423) 630-7001
Other practice location 4
58 Carroll Street
Lebanon, VA 24266-4510
Phone (276) 883-8000
Other practice location 5
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200
Other practice location 6
200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (704) 384-9437
Other practice location 7
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000
Other practice location 8
1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300
Other practice location 9
2030 Temple Hill Rd
Erwin, TN 37650-8721
Phone (423) 743-3141
Other practice location 10
1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1100
Other practice location 11
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000
Other practice location 12
245 Medical Park Dr
Marion, VA 24354-1100
Phone (276) 378-1000
Other practice location 13
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000
Other practice location 14
312 Hospital Dr
Clintwood, VA 24228-6786
Phone (276) 926-0300
Other practice location 15
400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Other practice location 16
851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000
Other practice location 17
15790 Paul Vega Dr
Hammond, LA 70403-1436
Phone (985) 230-1683
Other practice location 18
1102 W 32nd St
Joplin, MO 64804-3503
Phone (417) 347-4570
Other practice location 19
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121
Other practice location 20
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000
Other practice location 21
1519 Main St
Sneedville, TN 37869-3657
Phone (423) 733-5000
Other practice location 22
3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-4000
Other practice location 23
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000
Other practice location 24
1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (423) 230-8200
Other practice location 25
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NE, WA, CA, LA, NC, TN, VA, MO, IL, MS, CT, IN, GA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 15
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of Toledo College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Freeman-Oak Hill Health SystemWellmont Medical Associates IncNorth Oaks Medical Center LLC
Practice addresses (Care Compare)
Westport, CT 06880
Phone (773) 789-7976
1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000
1000 E Main St
Danville, IN 46122-1948
1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000
1035 Red Bud Rd NE
Calhoun, GA 30701-6010
1102 W 32 St
Joplin, MO 64804-3503
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000
150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811
1500 Clayton Manor Dr
Apt 6
Liverpool, NY 13088-5373
Phone (434) 200-5047
15790 Paul Vega MD Dr
Hammond, LA 70403-1434
Phone (985) 230-1683
16000 Johnson Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-8200
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000
3603 Bienville Blvd
Ocean Springs, MS 39564-5727
Phone (228) 872-8768
4763 Norstar Blvd
Apt 114
Liverpool, NY 13088-4219
Phone (985) 230-1683
7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622
707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone (706) 879-5760
8244 E US Hwy 36
Avon, IN 46123-9688
8244 E US Hwy 36 1320
Avon Internal Medicine
Avon, IN 46123-9688
Phone (317) 272-7519
PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460
Hospital & facility affiliations
- Stamford Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME162860 | FL | MD | Neurology Physician |
| 98412 | GA | MD | Neurology Physician |
| MD220867 | OR | MD | Neurology Physician |
| 310837 | NY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| North Oaks Medical Center, LLC | Current | Accepting new patients | |
| Westchester Medical Center Advanced Physician Services PC | Current | Accepting new patients | |
| Freeman-Oak Hill Health System | Current | Accepting new patients | |
| Veeone Medical Group II Professional Corporation | Neurology | Current | Accepting new patients |
| Northern Inyo Associates | Current | Accepting new patients | |
| Freeman-Oak Hill Health System | Neurology | Current | Accepting new patients |
| Hendricks County Hospital | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Northern Inyo Healthcare District | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients | |
| Wyoming County | Current | Accepting new patients | |
| Adventist Health System Georgia Inc | Current | Accepting new patients | |
| Hendricks County Hospital | Neurology | Current | Accepting new patients |
| Wakemed | Current | Accepting new patients | |
| North Oaks Medical Center, LLC | Current | Accepting new patients | |
| Neurology Medical Service Group, LLP | Neurology | Current | Accepting new patients |
| Riverside Health System | Current | Accepting new patients | |
| Veeone Medical Group PA | Neurology | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Neurology | Current | Accepting new patients |
| Multicare Health System | Current | Accepting new patients | |
| Hannibal Regional Healthcare System Inc | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Westchester Medical Center Advanced Physician Services, PC | Current | Accepting new patients | |
| Wyoming County | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Vidant Medical Group LLC | Current | Accepting new patients | |
| Wyoming County | Current | Accepting new patients | |
| North Atlanta Professional Services LLC | Current | Accepting new patients | |
| Wellmont Health System | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Stamford Health Medical Group Inc | Current | Accepting new patients | |
| Northern Inyo Healthcare District | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Wakemed | Current | Accepting new patients | |
| Hendricks County Hospital | Current | Accepting new patients | |
| Riverside Health System | Current | Accepting new patients | |
| Centra Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Wyoming County | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Singing River Health System | Current | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients |
Locations (25 of 71)
152 Pioneer Ln
Ste F
Bishop, CA 93514
Phone (760) 872-1606
150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136
1420 E Roseville Pkwy
Ste 140519
Roseville, CA 95661
1420 E Roseville Pkwy
Ste 140
Roseville, CA 95661
5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644
1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925
1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
699 Walnut St
Ste 400
Des Moines, IA 50309
Phone (515) 441-7944
375 N Wall St
Ste P510
Kankakee, IL 60901
Phone (815) 935-0750
105 S First St
Wilmington, IL 60481
Phone (815) 476-5210
8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500
8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510
301 Satori Pkwy
Ste 150
Avon, IN 46123
Phone (317) 272-3662
1100 Southfield Dr
Ste 1370
Plainfield, IN 46168
Phone (317) 837-5570
15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682
6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460
6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460
1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078
307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300
2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576
120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525
1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300
200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
- areddy1721385@direct.novanthealth.org
- areddy431583@balladhealth.medalliesdirect.net
- https://fhir4.healow.com/fhir/r4/ABCIBA
Organizations & group practices 51
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.
-
- Multi-Specialty Clinic/Center
- Calhoun, GA
- NPI 1699791343
-
- Multi-Specialty Clinic/Center
- Hannibal, MO
- NPI 1003956095
-
- General Practice Physician
- Danville, IN
- NPI 1497536163
-
- Psychologist
- Atlanta, GA
- NPI 1316959869
-
- Critical Access Hospital
- Bishop, CA
- NPI 1922198712
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Multi-Specialty Clinic/Center
- Gautier, MS
- NPI 1083893937
-
- General Practice Physician
- Stamford, CT
- NPI 1154633980
-
- Internal Medicine Physician
- Raleigh, NC
- NPI 1194907717
-
- Neurology Physician
- Syracuse, NY
- NPI 1518907096
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Stamford, CT
- NPI 1356331425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1548756588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-302-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132102306",
"telephone_number": "315-464-4243"
}
],
"practiceLocations": [
{
"address_1": "127 Health Care Dr Ste 3",
"address_purpose": "LOCATION",
"city": "Pennington Gap",
"state": "VA",
"postal_code": "242772853",
"country_code": "US",
"telephone_number": "423-230-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6000 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Hannibal",
"state": "MO",
"postal_code": "634016887",
"country_code": "US",
"telephone_number": "573-248-1300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 15th St NW",
"address_purpose": "LOCATION",
"city": "Norton",
"state": "VA",
"postal_code": "242731616",
"country_code": "US",
"telephone_number": "423-630-7001",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "58 Carroll Street",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "VA",
"postal_code": "242664510",
"country_code": "US",
"telephone_number": "276-883-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2801 N Gantenbein Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271623",
"country_code": "US",
"telephone_number": "503-413-2200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Hawthorne Ln",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042515",
"country_code": "US",
"telephone_number": "704-384-9437",
"fax_number": "704-384-9440",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 Johnson Ferry Rd",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303421606",
"country_code": "US",
"telephone_number": "404-851-8000",
"fax_number": "404-303-3759",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 W Elk Ave",
"address_purpose": "LOCATION",
"city": "Elizabethton",
"state": "TN",
"postal_code": "376432874",
"country_code": "US",
"telephone_number": "423-542-1300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2030 Temple Hill Rd",
"address_purpose": "LOCATION",
"city": "Erwin",
"state": "TN",
"postal_code": "376508721",
"country_code": "US",
"telephone_number": "423-743-3141",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1901 S Shady St",
"address_purpose": "LOCATION",
"city": "Mountain City",
"state": "TN",
"postal_code": "376832021",
"country_code": "US",
"telephone_number": "423-727-1100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16000 Johnston Memorial Dr",
"address_purpose": "LOCATION",
"city": "Abingdon",
"state": "VA",
"postal_code": "242117664",
"country_code": "US",
"telephone_number": "276-258-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "245 Medical Park Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "VA",
"postal_code": "243541100",
"country_code": "US",
"telephone_number": "276-378-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2000 Brookside Dr",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376604627",
"country_code": "US",
"telephone_number": "423-857-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "312 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Clintwood",
"state": "VA",
"postal_code": "242286786",
"country_code": "US",
"telephone_number": "276-926-0300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 N State Of Franklin Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046035",
"country_code": "US",
"telephone_number": "423-431-6111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "851 Locust St",
"address_purpose": "LOCATION",
"city": "Rogersville",
"state": "TN",
"postal_code": "378572407",
"country_code": "US",
"telephone_number": "423-921-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15790 Paul Vega Dr",
"address_purpose": "LOCATION",
"city": "Hammond",
"state": "LA",
"postal_code": "704031436",
"country_code": "US",
"telephone_number": "985-230-1683",
"fax_number": "985-230-6652",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1102 W 32nd St",
"address_purpose": "LOCATION",
"city": "Joplin",
"state": "MO",
"postal_code": "648043503",
"country_code": "US",
"telephone_number": "417-347-4570",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Park Blvd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207430",
"country_code": "US",
"telephone_number": "423-844-1121",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1420 Tusculum Blvd",
"address_purpose": "LOCATION",
"city": "Greeneville",
"state": "TN",
"postal_code": "377454279",
"country_code": "US",
"telephone_number": "423-787-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1519 Main St",
"address_purpose": "LOCATION",
"city": "Sneedville",
"state": "TN",
"postal_code": "378693657",
"country_code": "US",
"telephone_number": "423-733-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 Arlington Ave",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142595",
"country_code": "US",
"telephone_number": "419-383-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 W Ravine Rd",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603837",
"country_code": "US",
"telephone_number": "423-224-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1990 Holton Ave E",
"address_purpose": "LOCATION",
"city": "Big Stone Gap",
"state": "VA",
"postal_code": "242193350",
"country_code": "US",
"telephone_number": "423-230-8200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Med Tech Pkwy",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042277",
"country_code": "US",
"telephone_number": "423-302-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDDY",
"first_name": "ARAVIND",
"middle_name": "BIZWAR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-02",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME162860",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MO",
"license": "2023047334",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NV",
"license": "24278",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NC",
"license": "2023-00847",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "69079",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "VA",
"license": "0101279289",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "GA",
"license": "98412",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "310837",
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WA",
"license": "MD61349471",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036169458",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OR",
"license": "MD220867",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.