Active NPI
Elaine Tsukayama, MD
- Pediatrics Physician
- Utica, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 292820
- Practice address
- 117 Business Park Dr
Utica, NY 13502-6303 - Phone
- (315) 798-1543
- NPI assigned
- Jun 25, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 292820 | NY | Primary |
Addresses
Primary practice location
117 Business Park Dr
Utica, NY 13502-6303
Mailing address
117 Business Park Dr
Utica, NY 13502-6303
Phone (315) 798-1543
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05081741 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Loma Linda University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 Business Park Dr
Utica, NY 13502-6303
Phone (315) 798-1500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kapiolani Medical Specialists | Current | Accepting new patients | |
| United Medical Associates, P.C. | Current | Accepting new patients | |
| United Medical Associates PC | Current | Accepting new patients | |
| Slocum Dickson Medical Group PLLC | Current | Accepting new patients | |
| Wwu Campus Health & Wellness | Past | Accepting new patients |
Locations
1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300
33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156
33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412
1729 Burrstone Rd
New Hartford, NY 13413
Phone (315) 798-1500
179 River St
Oneonta, NY 13820
Phone (607) 432-8477
117 Business Park Dr
Utica, NY 13502
Phone (315) 798-1543
Interoperability endpoints
- etsukayama55898@mvhealthsystem.direct-ci.com
Organizations & group practices 5
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.
-
- Clinic/Center
- New Hartford, NY
- NPI 1285625996
-
- Clinic/Center
- Binghamton, NY
- NPI 1013972801
-
- Multi-Specialty Clinic/Center
- Honolulu, HI
- NPI 1124071014
-
- Durable Medical Equipment & Medical Supplies
- Binghamton, NY
- NPI 1629252556
-
- Student Health Clinic/Center
- College Place, WA
- NPI 1629048848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1578874459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 BUSINESS PARK DR",
"city": "UTICA",
"state": "NY",
"postal_code": "135026303",
"telephone_number": "315-798-1543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 BUSINESS PARK DR",
"city": "UTICA",
"state": "NY",
"postal_code": "135026303",
"telephone_number": "315-798-1543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSUKAYAMA",
"first_name": "ELAINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-25",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "292820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05081741",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.