Active NPI
Marc P Pietropaoli, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Skaneateles, NY
National Provider Identifier
1700895638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 206556
- Practice address
- 791 W Genesee Street Rd
Skaneateles, NY 13152-9377 - Phone
- (315) 685-7544
- Fax
- (315) 685-7549
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 206556 | NY | Primary |
Addresses
Primary practice location
791 W Genesee Street Rd
Skaneateles, NY 13152-9377
Mailing address
791 W Genesee Street Rd
Skaneateles, NY 13152-9377
Phone (315) 685-7544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206556 | NY | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Pietropaoli Medicine, PLLC | Current | Accepting new patients |
Locations
791 W Genesee Street Rd
Skaneateles, NY 13152
Phone (315) 685-7544
Interoperability endpoints
- drp@victorysportsmedicine.medentdirect.com
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Skaneateles, NY
- NPI 1326916610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1700895638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "791 W GENESEE STREET RD",
"city": "SKANEATELES",
"state": "NY",
"postal_code": "131529377",
"telephone_number": "315-685-7544",
"fax_number": "315-685-7549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "791 W GENESEE STREET RD",
"city": "SKANEATELES",
"state": "NY",
"postal_code": "131529377",
"telephone_number": "315-685-7544",
"fax_number": "315-685-7549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETROPAOLI",
"first_name": "MARC",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NY",
"license": "206556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skaneateles, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.