Upstate Surgical Group PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

UPSTATE SURGICAL GROUP PC

Practice address

5100 W Taft Rd
Ste 2E
Liverpool, NY 13088-3807

Phone

(315) 634-3399

Fax

(315) 634-3395

NPI assigned

Sep 20, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas F Certo, M.D.NPI 1881654119

Title

President

Phone

(315) 634-3399

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas F Certo, M.D.,

  • Surgery Physician
  • Liverpool, NY
  • NPI 1881654119
  NPD (past) Authorized official
• Balasubramaniam Sivakumar, M.D.,

  • Surgery Physician
  • Liverpool, NY
  • NPI 1134189483
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1629176755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "STE 2E",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-634-3399",
            "fax_number": "315-634-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "STE 2E",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-634-3399",
            "fax_number": "315-634-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE SURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CERTO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-634-3399",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01408800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph S Tutor, DDS
• Rukhshona Y Tuydieva
• Emasia Tyler
• University Hill Gastroenterology Associates, P.C.
• University Hill Gastroenterology Associates, P.C.
• Cassandra Vacco
• Nicole Michele Valentine, MS,CCC-SLP
• Brenda R Van Fossen, MD
• John H Van Slyke, M.D.
• Jessy Lyn Vanhorn

• Specialist in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.