Individual provider Active NPI

Victor J Croglio, M.D.

  • Internal Medicine Physician
  • East Syracuse, NY
National Provider Identifier
1639169162
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
156365 Issued in NY
Practice address
5000 Brittonfield Pkwy
Suite A100
East Syracuse, NY 13057-9226
Phone
(315) 449-3800
Fax
(315) 449-1246
NPI assigned
Oct 26, 2005
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 156365 NY Primary

Addresses

Primary practice location

5000 Brittonfield Pkwy
Suite A100
East Syracuse, NY 13057-9226

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 449-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vcroglio@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
I20050920000959 NY Practitioner - Internal MedicinePractitioner - Hospitalist 1951202845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
State University of Ny Upstate Medical University, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

5000 Brittonfield Pkwy
Suite A125
East Syracuse, NY 13057-9230
Phone (315) 802-2601

5000 Brittonfield Pkwy
Suite B101
East Syracuse, NY 13057-9226
Phone (315) 470-7409

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-7111

739 Irving Ave
Suite 500
Syracuse, NY 13210-1664
Phone (315) 470-7409

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156365NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Sep 1, 2013 Accepting new patients
Cny Internists, PC Internal Medicine CurrentSince Oct 2, 1996 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Aug 1, 2014 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
St. Camillus Residential Health Care Facility CurrentSince Jan 1, 2005 Accepting new patients
Crouse Health Hospital Inc CurrentSince Sep 1, 2013 Accepting new patients
Crouse Medical Practice, PLLC Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients
St. Camillus Residential Health Care Facility CurrentSince Jan 1, 2005 Accepting new patients

Locations

5000 Brittonfield Pkwy
#A10
East Syracuse, NY 13057

5000 Brittonfield Pkwy
Ste A100
East Syracuse, NY 13057
Phone (315) 449-3800

5000 Brittonfield Pkwy
Ste A1000
East Syracuse, NY 13057
Phone (315) 449-3800

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

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

813 Fay Rd
Syracuse, NY 13219
Phone (315) 464-5820

Interoperability endpoints

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

Organizations & group practices 9

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.

Hospital & facility affiliations 8

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1639169162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-449-3800",
            "fax_number": "315-499-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BRITTONFIELD PKWY",
            "address_2": "SUITE A100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579226",
            "telephone_number": "315-449-3800",
            "fax_number": "315-449-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROGLIO",
        "first_name": "VICTOR",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "156365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vcroglio@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "5000 Brittonfield Pkwy",
            "address_2": "Suite A100",
            "city": "East Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "130579226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.