Individual provider Active NPI

Suzanne M Bartol-Krueger, MD

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1699895730
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
242653-1 Issued in NY
Practice address
475 Irving Ave, Suite 108
Syracuse, NY 13210-3210
Phone
(315) 671-0070
Fax
(315) 475-0620
NPI assigned
Mar 30, 2007
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 242653-1 NY
Obstetrics & Gynecology Physician 207V00000X 242653-1 NY Primary

Addresses

Primary practice location

475 Irving Ave, Suite 108
Syracuse, NY 13210-3210

Mailing address

475 Irving Ave, Suite 108
Syracuse, NY 13210-3210
Phone (315) 671-0070

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
I20070921000434 NY Practitioner - Obstetrics/Gynecology 7911091939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of Ny Upstate Medical University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loftus, Ryu and Bartol MD's PCGroup PAC ID 6901990936, 6 clinicians

Practice addresses (Care Compare)

475 Irving Ave
Suite 108
Syracuse, NY 13210-1691
Phone (315) 671-0070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242653-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. Past Accepting new patients
Crouse Radiology Associates LLP PastSince Aug 1, 2007 Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1699895730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE, SUITE 108",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103210",
            "telephone_number": "315-671-0070",
            "fax_number": "315-475-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE, SUITE 108",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103210",
            "telephone_number": "315-671-0070",
            "fax_number": "315-475-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOL-KRUEGER",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "242653-1",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "242653-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.