Individual provider Active NPI

Robert C Cupelo, M.D.

  • Internal Medicine Physician
  • East Syracuse, NY
National Provider Identifier
1750371548
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
156924 Issued in NY
Practice address
5823 Widewaters Pkwy
East Syracuse, NY 13057-3071
Phone
(315) 449-4028
Fax
(315) 449-2341
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 156924 NY Primary

Addresses

Primary practice location

5823 Widewaters Pkwy
East Syracuse, NY 13057-3071

Mailing address

5823 Widewaters Pkwy
East Syracuse, NY 13057-3071
Phone (315) 449-4028

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
I20050920000988 NY Practitioner - Internal MedicinePractitioner - Hospitalist 3072414960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156924NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Aug 1, 2006 Accepting new patients
Erika Marie Hegland DO PC CurrentSince Feb 21, 2021 Accepting new patients
Crouse Health Hospital Inc CurrentSince Aug 1, 2006 Accepting new patients

Locations

5000 Brittonfield Pkwy
Ste A124
East Syracuse, NY 13057
Phone (315) 218-0430

5000 Brittonfield Pkwy
#A10
East Syracuse, NY 13057

5000 Brittonfield Pkwy
#A12
East Syracuse, NY 13057
Phone (315) 218-0430

5000 Brittonfield Pkwy
Ste A1000
East Syracuse, NY 13057
Phone (315) 449-3800

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1750371548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573071",
            "telephone_number": "315-449-4028",
            "fax_number": "315-449-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573071",
            "telephone_number": "315-449-4028",
            "fax_number": "315-449-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPELO",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "156924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.