Individual provider Active NPI

Syed Hassan Raza Bukhari, M.D.

  • Nephrology Physician
  • Syracuse, NY
National Provider Identifier
1801203898
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
298345 Issued in NY
Practice address
750 E Adams St # 343
Syracuse, NY 13210-2306
Phone
(315) 464-5290
Fax
(315) 464-5295
NPI assigned
Jul 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116030056 VA
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X 298345 NY Primary

Addresses

Primary practice location

750 E Adams St # 343
Syracuse, NY 13210-2306

Mailing address

750 E Adams St # 343
Syracuse, NY 13210-2306
Phone (315) 464-5290

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
I20190612002023 NY Practitioner - Nephrology 2668781543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

90 Presidential PLZ
Firmc
Syracuse, NY 13202-2240
Phone (315) 464-5788

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
298345NYMDLicensed Practical Nurse
0116030056VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Community Medical, PC Single Specialty CurrentSince Aug 15, 2021 Accepting new patients
Department of Medicine Medical Service Group Single Specialty CurrentSince Jul 1, 2019 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Single Specialty CurrentSince Jul 1, 2019 Accepting new patients

Locations

21 Nelson St
Auburn, NY 13021
Phone (315) 255-9004

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

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

90 Presidential Plz
#C
Syracuse, NY 13202
Phone (315) 464-3834

750 E Adams St
#343
Syracuse, NY 13210
Phone (315) 464-5290

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

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

Interoperability endpoints

  • Direct secure messaging: sbukhari90429@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 3

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1801203898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST # 343",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5290",
            "fax_number": "315-464-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST # 343",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5290",
            "fax_number": "315-464-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKHARI",
        "first_name": "SYED HASSAN",
        "middle_name": "RAZA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116030056",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "298345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.