Department of Medicine MSG

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DEPARTMENT OF MEDICINE MSG

Practice address

90 Presidential PLZ
Syracuse, NY 13202-2240

Phone

(315) 464-4505

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Michael C. Iannuzzi, MD

Title

President

Phone

(315) 464-4505

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Department of Medicine MSG6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Department of Medicine

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1740443548
  NPD tax ID
• Department of Medicine MSG

  • Cardiovascular Disease Physician
  • Manlius, NY
  • NPI 1205856093
  NPD tax ID
• Department of Medicine MSG

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1396765632
  NPD tax ID
• Department of Medicine MSG

  • Gastroenterology Physician
  • Syracuse, NY
  • NPI 1871513689
  NPD tax ID
• University Hospital Physicians

  • Clinic/Center
  • Oneida, NY
  • NPI 1861599169
  NPD tax ID

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1699799148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MEDICINE MSG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "IANNUZZI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-464-4505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Medicine
• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr at Syr in
• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in
• Department of Medicine Medical Service Group
• Department of Medicine MSG
• Department of Medicine MSG
• Department of Veterans Affairs
• Aimee B Derbyshire
• Dean Edgar Derbyshire, PHARM.D.
• Lauren Deritter, RPH

• All providers in Syracuse, NY
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.