Individual provider Active NPI

Paul Ruggeri III

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1730090499
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
834934 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-5540
NPI assigned
Sep 14, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 834934 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

4776 Sabre LN
Manlius, NY 13104-2024
Phone (315) 289-5487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1730090499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4776 SABRE LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042024",
            "telephone_number": "315-289-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGERI",
        "first_name": "PAUL",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "834934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.