Ian Trevor Daly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

272973 Issued in NY

Practice address

5700 W Genesee St
Family Care Medical Group, Ste. 109N
Camillus, NY 13031-3200

Phone

(315) 487-1573

Fax

(315) 487-2418

NPI assigned

Apr 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
• Hospice of Central New York Hospice, Liverpool, NY, CCN 331511
• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: idaly@fcmg.medentdirect.com

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.

• Familycare Medical Group, PC

  • Family Medicine Physician
  • Syracuse, NY
  • NPI 1447212063
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• QC-Medi New York, Inc.

  dba CenterWell Home Health

  • Home Health Agency
  • Syracuse, NY
  • NPI 1912939489
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation
• The Caring Coalition of Central New York

  dba Hospice of Central New York

  • Community Based Hospice Care Agency
  • Liverpool, NY
  • NPI 1912098666
  Care Compare affiliation

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1568753978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "FAMILY CARE MEDICAL GROUP, STE. 109N",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-487-1573",
            "fax_number": "315-487-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "FAMILY CARE MEDICAL GROUP, STE. 109N",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-487-1573",
            "fax_number": "315-487-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "IAN",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "63069",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "272973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mireille Cruz, DMD
• Elizabeth Lynn Cullen, DPT
• Virginia S Cummings
• John A Dale, MD
• Dennis David Daly, MD
• Dung T Dang, PHARMD
• Daniel L. Dombroski, M.D., P.C.
• David Babb LMHC LLC
• Kristen Davis, MS, RD, CDN
• Sydney Degirolamo, PHARMD

• Family Medicine Physician in Camillus, NY
• Providers in Camillus, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.

Verify at the official NPI Registry.