Individual provider Active NPI

Michael John Degennaro, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1659605988
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
563264 Issued in NY
Practice address
301 Prospect Ave
Anesthesia Group of Onondaga PC
Syracuse, NY 13203-1807
Phone
(315) 448-5440
Fax
(315) 472-5010
NPI assigned
Sep 18, 2009
Last updated
Mar 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 563264 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Anesthesia Group of Onondaga PC
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave.
Anesthesia Group of Onondaga, PC
Syracuse, NY 13203-1807
Phone (315) 448-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000653 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628112448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph's Physician Health PCGroup PAC ID 9436041431, 125 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
39.78 of 100Reported as group
Quality
24.5
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Physician Health, P.C. CurrentSince Jun 1, 2024 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Mar 1, 2021 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

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.

Hospital & facility affiliations 1

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": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1659605988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE.",
            "address_2": "ANESTHESIA GROUP OF ONONDAGA, PC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "ANESTHESIA GROUP OF ONONDAGA PC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "563264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.