NPIMap

Organization Active NPI

New York Anesthesiology Medical Specialties PC

Doing business as New York Spine and Wellness Center

  • Interventional Pain Medicine Physician
  • North Syracuse, NY
National Provider Identifier
1841285996
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES PC
Doing business as
New York Spine and Wellness Center
Practice address
5496 E Taft Rd
North Syracuse, NY 13212-3784
Phone
(315) 552-6700
Fax
(315) 552-6701
NPI assigned
Sep 14, 2005
Last updated
Feb 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Authorized official

Name
Robert L Tiso, MDNPI 1942295092
Title
President
Phone
(315) 552-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5496 E Taft Rd
North Syracuse, NY 13212-3784

Mailing address

PO Box 510
Syracuse, NY 13214-0510
Phone (315) 703-3484

Other names 1

  • New York Spine and Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040331000822 NY Part B Supplier - Clinic/Group Practice 3375535396 Receives reassigned benefits from 30 practitioners
Practice locations: North Syracuse, NY; Syracuse, NY; East Syracuse, NY; Camillus, NY
O20100930085380 NY DME Supplier - Physician - General Surgery 3375535396 Practice locations: N Syracuse, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1084608New York Anesthesiology Medical Specialties5496 East Taft Road - Suite 2a, North Syracuse, NY 13212ComplianceSep 17, 2027

National Provider Directory

National Provider Directory

Locations

5417 W Genesee St
Ste 1
Camillus, NY 13031
Phone (315) 432-4900

5496 E Taft Rd
Syracuse, NY 13212
Phone (315) 552-6700

5496 E Taft Rd
Ste A
Syracuse, NY 13212
Phone (315) 552-6700

Interoperability endpoints

  • Direct secure messaging: adrianneoquinn@nysw.allscriptsdirect.net
  • Direct secure messaging: brendanmcginn@nysw.allscriptsdirect.net
  • Direct secure messaging: christophermorris@nysw.allscriptsdirect.net
  • Direct secure messaging: dinomazzara@nysw.allscriptsdirect.net
  • Direct secure messaging: erictallarico@nysw.allscriptsdirect.net
  • Direct secure messaging: josephcatania@nysw.allscriptsdirect.net
  • Direct secure messaging: katieouderkirk@nysw.allscriptsdirect.net
  • Direct secure messaging: lindseysmith@nysw.allscriptsdirect.net
  • Direct secure messaging: marytrusilo@nysw.allscriptsdirect.net
  • Direct secure messaging: raymondalcuri@nysw.allscriptsdirect.net
  • Direct secure messaging: rinadavis@nysw.allscriptsdirect.net
  • Direct secure messaging: roberttiso@nysw.allscriptsdirect.net
  • Direct secure messaging: ryanmcconn@nysw.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1841285996",
    "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": "315-703-3484",
            "fax_number": "315-703-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-552-6700",
            "fax_number": "315-552-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "TISO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-552-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.