NPIMap

Organization Active NPI

Upstate Orthopedics, LLP

  • Orthopaedic Surgery Physician
  • East Syracuse, NY
National Provider Identifier
1740228311
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
UPSTATE ORTHOPEDICS, LLP
Practice address
6620 Fly Road
Ste 200
East Syracuse, NY 13057
Phone
(315) 464-4472
Fax
(315) 464-5529
NPI assigned
Jun 3, 2006
Last updated
Oct 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Stephen A. Albanese, MDNPI 1952305369
Title
Orthopedic Department Chairman
Phone
(315) 464-4472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 146522 NY
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

6620 Fly Road
Ste 200
East Syracuse, NY 13057

Mailing address

6620 Fly Road
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472

Other identifiers 1

IdentifierTypeStateIssuer
01274166MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001452 NY Part B Supplier - Clinic/Group Practice 1456344514 Receives reassigned benefits from 46 practitioners
Practice locations: Camillus, NY; East Syracuse, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

208 Township Blvd
Camillus, NY 13031
Phone (315) 551-6000

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1740228311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 FLY ROAD",
            "address_2": "STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 FLY ROAD",
            "address_2": "STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE ORTHOPEDICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "ALBANESE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ORTHOPEDIC DEPARTMENT CHAIRMAN",
        "authorized_official_telephone_number": "315-464-4472",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "146522",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274166",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.