NPIMap

Organization Active NPI

New York Anesthesiology Medical Specialties, PC

  • Pain Medicine Physician
  • Liverpool, NY
National Provider Identifier
1770958100
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Practice address
5100 W Taft Rd Ste 1B
Liverpool, NY 13088-3808
Phone
(315) 552-6739
NPI assigned
Dec 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Robert Tiso
Title
MD/Director
Phone
(315) 552-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

5100 W Taft Rd Ste 1B
Liverpool, NY 13088-3808

Mailing address

PO Box 510
Syracuse, NY 13214-0510
Phone (315) 251-3105

Other identifiers 1

IdentifierTypeStateIssuer
03423585MedicaidNY

Other names 1

  • New York Spine and Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New York Anesthesiology Medical Specialties PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

180 Park Club Ln
Ste 250
Williamsville, NY 14221
Phone (716) 580-3380

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1770958100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132140510",
            "telephone_number": "315-251-3105",
            "fax_number": "315-552-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 1B",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883808",
            "telephone_number": "315-552-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "TISO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD/DIRECTOR",
        "authorized_official_telephone_number": "315-552-6700"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03423585",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.