Individual provider Active NPI

Jama S Sy, M.D.

  • Pediatric Critical Care Medicine Physician
  • Toledo, OH
National Provider Identifier
1689617086
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
35091363 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 291-2207
Fax
(419) 479-6998
NPI assigned
Jun 14, 2006
Last updated
Oct 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M3400 TX
Pediatric Critical Care Medicine Physician 2080P0203X 35091363 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-2207

Other identifiers 2

IdentifierTypeStateIssuer
2833545MedicaidOH
48666OtherHEALTH PLAN OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171002000410 FL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 6709887490 Reassigns benefits to 1 organization
I20220323002783 NV Practitioner - Pediatric Medicine 6709887490 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35091363OHMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Florida Inc Pediatric Critical Care Medicine CurrentSince Jul 5, 2017 Accepting new patients
Pokroy Medical Group of Nevada, LTD. Pediatrics CurrentSince Feb 1, 2022 Accepting new patients
Promedica Children's Specialists Pediatrics PastSince Jan 1, 2017 Accepting new patients

Locations

File 50978
Los Angeles, CA 90074

3100 SW 62nd Ave
Miami, FL 33155
Phone (305) 669-5873

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

12969 S US 301
Riverview, FL 33578
Phone (813) 971-6909

1300 Sawgrs Corp Pkwy
Ste 200
Sunrise, FL 33323
Phone (954) 384-0175

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

Interoperability endpoints

  • Direct secure messaging: jsy21879@tallahasseememorial.direct-ci.com

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, 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1689617086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-2207",
            "fax_number": "419-479-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-2207",
            "fax_number": "419-479-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "JAMA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M3400",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OH",
            "license": "35091363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2833545",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "48666",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.