Active NPI
Daniel P Cannucciari, M.D.
- Diagnostic Radiology Physician
- Auburn, NY
National Provider Identifier
1629061106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 138429
- Practice address
- 281 Grant Ave
Auburn, NY 13021-1421 - Phone
- (315) 255-2828
- Fax
- (315) 255-3503
- NPI assigned
- Aug 30, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 138429 | NY | Primary |
Addresses
Primary practice location
281 Grant Ave
Auburn, NY 13021-1421
Mailing address
4567 Crossroads Park Dr
Liverpool, NY 13088-3589
Phone (315) 295-2100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00709031 | Medicaid | NY |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crouse Radiology Associates LLP | Diagnostic Radiology | Past | Accepting new patients |
| Syracuse Orthopedic Specialists, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Syracuse, NY
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- Syracuse, NY
- NPI 1669410379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1629061106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4567 CROSSROADS PARK DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883589",
"telephone_number": "315-295-2100",
"fax_number": "315-295-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 GRANT AVE",
"city": "AUBURN",
"state": "NY",
"postal_code": "130211421",
"telephone_number": "315-255-2828",
"fax_number": "315-255-3503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNUCCIARI",
"first_name": "DANIEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "138429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00709031",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.