Individual provider Active NPI

Andres M Madissoo, M.D.

  • Urology Physician
  • Syracuse, NY
National Provider Identifier
1770570517
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
203934 Issued in NY
Practice address
1226 E Water St
Syracuse, NY 13210-1155
Phone
(315) 478-4185
Fax
(315) 478-0840
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 203934 NY Primary

Addresses

Primary practice location

1226 E Water St
Syracuse, NY 13210-1155

Mailing address

1226 E Water St
Syracuse, NY 13210-1155
Phone (315) 478-4185

Other identifiers 1

IdentifierTypeStateIssuer
02084128MedicaidNY

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
I20071203000467 NY Practitioner - Urology 4385654672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
State University of New York at Buffalo School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Medical Professionals of Ny PLLCGroup PAC ID 0749378123, 57 clinicians

Practice addresses (Care Compare)

4211 Medical Ctr Dr
Suite 211
Fayetteville, NY 13066-6637
Phone (315) 297-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Jan 1, 2008 Accepting new patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Jan 1, 2008 Accepting new patients

Locations

4000 Medical Center Dr
Ste 211
Fayetteville, NY 13066

4211 Medical Center Dr
#211
Fayetteville, NY 13066
Phone (315) 297-4700

5100 W Taft Rd
Ste 4J
Liverpool, NY 13088
Phone (315) 701-2170

100 Metropolitan Park Dr
Ste 100
Liverpool, NY 13088
Phone (315) 870-9370

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

Interoperability endpoints

  • Direct secure messaging: amadissoo@ampofny.medentdirect.com

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 5

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1770570517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISSOO",
        "first_name": "ANDRES",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "203934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.