Individual provider Active NPI

Michael Mix, MD

  • Radiation Oncology Physician
  • Syracuse, NY
National Provider Identifier
1720379233
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
283872 Issued in NY
Practice address
750 E Adams St
Department of Radiation Oncology
Syracuse, NY 13210-2306
Phone
(315) 464-5276
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 283872 NY Primary

Addresses

Primary practice location

750 E Adams St
Department of Radiation Oncology
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Department of Radiation Oncology
Syracuse, NY 13210-2306
Phone (315) 464-5276

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
I20160929002007 NY Practitioner - Radiation Oncology 6204123540 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians
Auburn Community HospitalGroup PAC ID 2365346525, 61 clinicians
Upstate University Radiation Oncology IncGroup PAC ID 7719012889, 15 clinicians

Practice addresses (Care Compare)

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 756-3500

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7142

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
283872NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Dec 1, 2018 Accepting new patients
Upstate University Radiation Oncology, Inc. Radiation Oncology CurrentSince Sep 1, 2016 Accepting new patients
Auburn Community Hospital CurrentSince Feb 1, 2024 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 1, 2020 Accepting new patients
MVHS Inc CurrentSince Dec 1, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 1, 2020 Accepting new patients
Auburn Community Hospital CurrentSince Feb 1, 2024 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

5 Lansing St
Auburn, NY 13021
Phone (315) 253-1818

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

105 County Route 45A
Ste 200
Oswego, NY 13126
Phone (315) 207-9066

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

1000 E Genesee St
Ste 101
Syracuse, NY 13210
Phone (315) 471-3535

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: mmix163270@direct-guthrie.org
  • Direct secure messaging: mmix6918@direct.upstate.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1720379233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "DEPARTMENT OF RADIATION ONCOLOGY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "DEPARTMENT OF RADIATION ONCOLOGY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIX",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "283872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.