Individual provider Active NPI

Rajin Shahriar, MD

  • Pediatric Orthopaedic Surgery Physician
  • East Syracuse, NY
National Provider Identifier
1679815260
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
306484 Issued in NY
Practice address
6620 Fly Rd Ste 200
East Syracuse, NY 13057-4282
Phone
(315) 464-4472
Fax
(315) 464-5222
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 306484 NY
Pediatric Orthopaedic Surgery Physician 207XP3100X 306484 NY Primary

Addresses

Primary practice location

6620 Fly Rd Ste 200
East Syracuse, NY 13057-4282

Mailing address

6620 Fly Rd Ste 200
East Syracuse, NY 13057-4282
Phone (315) 464-4472

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
I20201007001454 NY Practitioner - Orthopedic Surgery 7810252855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Texas a & M University System, HSC, College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Orthopedics, LLPGroup PAC ID 1456344514, 33 clinicians

Practice addresses (Care Compare)

208 Township Blvd
Suite 200
Camillus, NY 13031-1674
Phone (315) 551-6000

6620 Fly Rd
Suite 100
East Syracuse, NY 13057-4281
Phone (315) 484-4472

Merit-based Incentive Payment System (MIPS)

Final score
91.43 of 100Reported as group
Quality
90.7
Promoting interoperability
100
Improvement activities
40
Cost
80.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306484NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Upstate Orthopedics, LLP Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

208 Township Blvd
Ste 200
Camillus, NY 13031
Phone (315) 464-4472

6620 Fly Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 464-4472

6620 Fly Rd
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472

Interoperability endpoints

  • Direct secure messaging: rshahriar110115@direct.upstate.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1679815260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 FLY RD STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574282",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 FLY RD STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574282",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRIAR",
        "first_name": "RAJIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "306484",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NY",
            "license": "306484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.