Cynthia Jacildone Baltazar, M.D.
Individual provider Active NPI Internal Medicine Physician · Potsdam, NY
NPI 1790782548 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1790782548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 183241 (NY)
- Practice address
- 50 Leroy St
Potsdam, NY 13676-1799 - Phone
- (315) 265-3300
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Canton-Potsdam Hospital
Practice addresses (Care Compare)
50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300
Hospital & facility affiliations
- Canton-Potsdam Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.56 of 100
- Quality
- 87.76
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040518000527 | NY | Practitioner - Internal Medicine | 8022925841 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 183241 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current |
Accepting new patients | |
| Canton-Potsdam Hospital | Current |
Accepting new patients | |
| Adirondack Physical & Occupational Therapy, LLC | Past | Accepting new patients |
Locations
80 E Main St
Canton, NY 13617
Phone (315) 261-6034
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
Interoperability endpoints
- cbaltazar338541@direct.rochesterregional.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 183241 | NY | Yes |
Addresses
Primary practice location
50 Leroy St
Potsdam, NY 13676-1799
Mailing address
50 Leroy St
Potsdam, NY 13676-1799
Phone (315) 265-3300
Other practice location 1
8 Gulf Rd
Colton, NY 13625-0008
Phone (315) 262-2287
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01203869 | Medicaid | NY |
Other names
- Dr. Cynthia J Baltazar
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cbaltazar338541@direct.rochesterregional.org |
Other providers in Potsdam, NY
- Bernadette Avila
- Ricardo Luis Baez
- Anna Bair
- Katherine A Baker
- Sarah Baker
- Vineet Bansal
- Tracie L. Barnes
- Danielle Barse
- Jillian Bartling
- Carrie Bascom
All providers in Potsdam, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.