Individual provider Active NPI

Clyde Satterly, MD

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1760428908
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
202023 Issued in NY
Practice address
475 Irving Ave
Ste 200
Syracuse, NY 13210-1756
Phone
(315) 464-4686
Fax
(315) 464-7106
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 202023 NY Primary

Addresses

Primary practice location

475 Irving Ave
Ste 200
Syracuse, NY 13210-1756

Mailing address

475 Irving Ave
Ste 200
Syracuse, NY 13210-1756
Phone (315) 464-4686

Other identifiers 1

IdentifierTypeStateIssuer
01809934MedicaidNY

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
I20061025000297 NY Practitioner - Family Practice 0941207518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upstate Family and Preventive Medicine IncGroup PAC ID 6800185711, 30 clinicians

Practice addresses (Care Compare)

6712 Brooklawn Pkwy
Suite 204
Syracuse, NY 13211-2158
Phone (315) 432-8899

725 E Adams St
Syracuse, NY 13210-2576
Phone (315) 464-4686

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
85.15
Promoting interoperability
100
Improvement activities
40
Cost
80.95

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Family and Preventive Medicine, Inc Family Medicine CurrentSince Mar 5, 2016 Accepting new patients
Lakeshore Family Medicine, P.C. PastSince Jul 31, 2006 Accepting new patients

Locations

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

90 Presidential Plz
Fl 2
Syracuse, NY 13202
Phone (315) 464-3833

475 Irving Ave
Ste 300
Syracuse, NY 13210
Phone (315) 464-3555

6712 Brooklawn Pkwy
Ste 204
Syracuse, NY 13211
Phone (315) 432-8899

475 Irving Ave
Ste 200
Syracuse, NY 13210
Phone (315) 464-4686

Interoperability endpoints

  • Direct secure messaging: csatterly2494@direct.upstate.edu

Organizations & group practices 2

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 1

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1760428908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "STE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-4686",
            "fax_number": "315-464-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "STE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-4686",
            "fax_number": "315-464-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTERLY",
        "first_name": "CLYDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "202023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01809934",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.