Individual provider Active NPI

Ayesha Aziz, MD

  • Internal Medicine Physician
  • Manlius, NY
National Provider Identifier
1679513436
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209420 Issued in NY
Practice address
102 W Seneca St
Manlius, NY 13104-2480
Phone
(315) 682-6600
NPI assigned
Jun 8, 2006
Last updated
Dec 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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 209420 NY Primary

Addresses

Primary practice location

102 W Seneca St
Manlius, NY 13104-2480

Mailing address

739 Irving Ave Ste 200
Syracuse, NY 13210-1668
Phone (315) 479-5070

Other identifiers 1

IdentifierTypeStateIssuer
01627238MedicaidNY

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
I20140317000392 NY Order and Referring Only - General PracticePractitioner - General Practice 8325079429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209420NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Group Health Association Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aaziz@hiemail.healtheconnections.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1679513436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101668",
            "telephone_number": "315-479-5070",
            "fax_number": "315-701-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W SENECA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042480",
            "telephone_number": "315-682-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZ",
        "first_name": "AYESHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01627238",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

Verify at the official NPI Registry.