NPIMap

Individual provider Active NPI

Patsy M Iannolo, M.D.

  • Internal Medicine Physician
  • N Syracuse, NY
National Provider Identifier
1821138165
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
155664 Issued in NY
Practice address
5180 W Taft Rd
N Syracuse, NY 13212-2601
Phone
(315) 458-4622
Fax
(315) 458-9629
NPI assigned
Feb 7, 2007
Last updated
Mar 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 155664 NY
Internal Medicine Physician 207R00000X 155664 NY Primary

Addresses

Primary practice location

5180 W Taft Rd
N Syracuse, NY 13212-2601

Mailing address

PO Box 346
N Syracuse, NY 13212-0346
Phone (315) 458-4622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000444 NY Practitioner - Internal MedicinePractitioner - Emergency Medicine 7810953726 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

17 Lansing St
Suite 201
Auburn, NY 13021-1983
Phone (315) 252-8838

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155664NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Emergency Medicine CurrentSince Nov 3, 2008 Accepting new patients
Auburn Memorial Medical Services, PC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Port City Emergency Physicians LLP Emergency Medicine CurrentSince Nov 3, 2008 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince May 1, 2023 Accepting new patients

Locations

17 Lansing St
Ste 201
Auburn, NY 13021
Phone (315) 252-7434

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Interoperability endpoints

  • Direct secure messaging: patsy.iannolo@dpmim-ny.direct.office.nextgen.com
  • Direct secure messaging: piannolo@amms.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Auburn Community HospitalAuburn, NY, CCN 33S235 Hospital Corporate Officer Jan 1, 2013
Auburn Community HospitalAuburn, NY, CCN 330235 Hospital Corporate Officer Jan 1, 2014
Auburn Community HospitalAuburn, NY, CCN 335785 Skilled nursing facility Corporate Director Jan 1, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1821138165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 346",
            "city": "N SYRACUSE",
            "state": "NY",
            "postal_code": "132120346",
            "telephone_number": "315-458-4622",
            "fax_number": "315-458-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 W TAFT RD",
            "city": "N SYRACUSE",
            "state": "NY",
            "postal_code": "132122601",
            "telephone_number": "315-458-4622",
            "fax_number": "315-458-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNOLO",
        "first_name": "PATSY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "155664",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "155664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Syracuse, NY

Sources for this page

Verify at the official NPI Registry.