Individual provider Active NPI

Tammy J Congelli, MD

  • Surgery Physician
  • Syracuse, NY
National Provider Identifier
1619927894
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2095421 Issued in NY
Practice address
739 Irving Ave
Suite 450
Syracuse, NY 13210
Phone
(315) 470-7364
Fax
(315) 470-5859
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2095421 NY Primary

Addresses

Primary practice location

739 Irving Ave
Suite 450
Syracuse, NY 13210

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

Other identifiers 1

IdentifierTypeStateIssuer
02107660MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tammycongelli@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

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
I20100208000381 NY Practitioner - General Surgery 8123161528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of Ny Upstate Medical University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

739 Irving Ave
Suite 450
Syracuse, NY 13210-1663
Phone (315) 470-7364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy48
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2095421NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Mar 2, 2022 Accepting new patients
Crouse Health Hospital Inc Surgery CurrentSince Mar 2, 2022 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Jan 1, 2020 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Jan 1, 2020 Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

436 Hinsdale Rd
Camillus, NY 13031
Phone (315) 488-0996

8324 Oswego Rd
Ste E
Liverpool, NY 13090
Phone (315) 470-7364

475 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 470-7291

739 Irving Ave
Ste 300
Syracuse, NY 13210
Phone (315) 475-8599

739 Irving Ave
Ste 450
Syracuse, NY 13210
Phone (315) 470-7364

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

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Interoperability endpoints

  • Direct secure messaging: tcongelli@crousemed.medentdirect.com
  • Direct secure messaging: tcongelli@hiemail.healtheconnections.org

Organizations & group practices 6

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 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1619927894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433",
            "fax_number": "315-470-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 450",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-470-7364",
            "fax_number": "315-470-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGELLI",
        "first_name": "TAMMY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "2095421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02107660",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tammycongelli@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Syracuse",
            "address_1": "739 Irving Ave",
            "address_2": "Suite 450",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "13210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.