Individual provider Active NPI

Roberto E Izquierdo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Syracuse, NY
National Provider Identifier
1760423347
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
183878 Issued in NY
Practice address
725 E. Adams Street
5TH FL
Syracuse, NY 13210
Phone
(315) 464-5726
Fax
(315) 464-2500
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 183878 NY Primary

Addresses

Primary practice location

725 E. Adams Street
5TH FL
Syracuse, NY 13210

Mailing address

725 E. Adams Street
5TH FL
Syracuse, NY 13210
Phone (315) 464-5726

Other identifiers 1

IdentifierTypeStateIssuer
01480877MedicaidNY

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
I20050523000886 NY Practitioner - EndocrinologyPractitioner - Pediatric Medicine 9032151881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Pediatric Medicine
Education
State University of Ny Upstate Medical University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

725 E Adams St
Syracuse, NY 13210-2576

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4457

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.56 of 100Reported as group
Quality
71.97
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183878NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Service Group CurrentSince Oct 16, 1995 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Endocrinology, Diabetes & Metabolism CurrentSince Oct 16, 1995 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

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

3229 E Genesee St
Syracuse, NY 13214
Phone (315) 446-7501

725 E Adams St
Fl 5
Syracuse, NY 13210
Phone (315) 464-5726

Interoperability endpoints

  • Direct secure messaging: rizquierdo7292@direct.upstate.edu

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1760423347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E. ADAMS STREET",
            "address_2": "5TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E. ADAMS STREET",
            "address_2": "5TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "ROBERTO",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "183878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01480877",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.