Individual provider Active NPI

Laura Nicolais, MD

  • Colon & Rectal Surgery Physician
  • Syracuse, NY
National Provider Identifier
1801391727
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
337239 Issued in NY
Practice address
4900 Broad Road
Suite 2B North
Syracuse, NY 13215-2265
Phone
(315) 492-5036
Fax
(315) 492-5477
NPI assigned
Mar 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 337239 NY Primary
Colon & Rectal Surgery Physician 208C00000X 036.169867 IL

Addresses

Primary practice location

4900 Broad Road
Suite 2B North
Syracuse, NY 13215-2265

Mailing address

4900 Broad Road
Suite 2B North
Syracuse, NY 13215-2265
Phone (315) 492-5036

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
I20250918003096 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 3476900630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
State University of Ny Upstate Medical University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Surgical Associates LLPGroup PAC ID 7315834165, 49 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

725 Irving Ave
Suite 401
Syracuse, NY 13210-1684
Phone (315) 464-2878

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.169867ILMDColon & Rectal Surgery Physician
337239NYMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical Associates, LLP Colon & Rectal Surgery CurrentSince Sep 2, 2025 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

4900 Broad Rd
Ste 2B
Syracuse, NY 13215
Phone (315) 492-5036

4900 Broad Rd
Ste 2BN
Syracuse, NY 13215

725 Irving Ave
Ste 401
Syracuse, NY 13210
Phone (315) 464-2878

Interoperability endpoints

  • Direct secure messaging: lnicolais173620@uihealth.direct-ci.com
  • Direct secure messaging: lnicolais55584@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": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1801391727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROAD ROAD",
            "address_2": "SUITE 2B NORTH",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5036",
            "fax_number": "315-492-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD ROAD",
            "address_2": "SUITE 2B NORTH",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5036",
            "fax_number": "315-492-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAIS",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "337239",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036.169867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.