Upstate Community Medical, PC
Organization Active NPI Hospitalist Physician · Syracuse, NY
NPI 1689620163 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1689620163
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- UPSTATE COMMUNITY MEDICAL, PC
- Practice address
- 4900 Broad Rd
Syracuse, NY 13215-2265 - Phone
- (315) 492-5305
- Fax
- (315) 492-5320
- NPI assigned
- May 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Amy Tucker, MD
- Title
- President
- Phone
- (315) 464-4255
Practitioners 310
-
Basel Abuzuaiter, MD
-
Sumera Ahmed, MD
-
Soumya Aleti, MD
-
Asad Ali, MBBS
-
Ioana G. Amzuta, M.D.
-
Jamie Kaye Bach, MSN, SCRN, ACNPC-AG
-
Meghan B. Baier, CNM
-
Miriam Beth Bernstein, M.D.
-
Justin Bernard Bertrand, M.D.
-
Tinaz H Bhutta, MD
-
Vishal Busa, MD
-
Ryan Butzko, DO
-
Himal Chapagain, MD
-
Manasa Chitneni, MD
-
Jennifer Chiu, NP-C
-
Sakshi Dutta, M.D.
-
Mohamed Eisa, MD
-
Mark J Emerick, MD
-
Christine Feliu, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060323000644 | NY | Part B Supplier - Clinic/Group Practice | 0143238782 |
Receives reassigned benefits from 297 practitioners Practice locations: Syracuse, NY; Camillus, NY; Baldwinsville, NY |
National Provider Directory
Locations
8278 Willett Pkwy
Baldwinsville, NY 13027
Phone (315) 452-2525
8278 Willett Pkwy
Ste 101
Baldwinsville, NY 13027
Phone (315) 635-1573
4900 Broad Rd
Ste 2H
Syracuse, NY 13215
Phone (315) 299-5313
4900 Broad Rd
#4H
Syracuse, NY 13215
4900 Broad Rd
Ste D1
Syracuse, NY 13215
Phone (315) 492-5678
4900 Broad Rd
Ste 2V
Syracuse, NY 13215
Phone (315) 492-5005
4900 Broad Rd
Rm 1352
Syracuse, NY 13215
4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | |||
| Surgery Physician |
208600000X | |||
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
4900 Broad Rd
Syracuse, NY 13215-2265
Mailing address
1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 472-1488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02771722 | Medicaid | NY | |
| DE7448 | Other | NY | RR MEDICARE PIN |
Other providers in Syracuse, NY
- University Surgical Associates, LLP
- University Urology Associates, Inc
- Ramona Vesna Untanu
- Molly Upah
- Updesign Primary Care, LLC
- Upstate Emergency Medicine, Inc
- Upstate Family and Preventive Medicine, Inc
- Upstate Gastroenterology, LLC
- Upstate Medical Anesthesiology Group, Inc.
- Upstate Medical Center
All providers in Syracuse, NY · Hospitalist Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.