Individual provider Active NPI

Bruce A Kahn, J.D., M.D.

  • Psychiatry Physician
  • Syracuse, NY
National Provider Identifier
1558415752
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
178464 Issued in NY
Practice address
201 Prospect Ave
Syracuse, NY 13203-1805
Phone
(315) 448-6463
Fax
(315) 448-6510
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 178464 NY Primary

Addresses

Primary practice location

201 Prospect Ave
Syracuse, NY 13203-1805

Mailing address

9 Enright Street
Mysterton, QUEENSLAND 4812
AU
Phone 61747753088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Behavioral Health Incorporated Psychiatry Past Accepting new patients
St Josephs Hospital Health Center Past Accepting new patients
State of Wyoming PastSince Jan 28, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1558415752",
    "addresses": [
        {
            "country_code": "AU",
            "country_name": "Australia",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "9 ENRIGHT STREET",
            "city": "MYSTERTON",
            "state": "QUEENSLAND",
            "postal_code": "4812",
            "telephone_number": "61747753088",
            "fax_number": "435-604-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031805",
            "telephone_number": "315-448-6463",
            "fax_number": "315-448-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "J.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "178464",
            "primary": true
        }
    ],
    "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 Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.