NPIMap

Organization Active NPI

Crouse Health Hospital Inc

  • Hospitalist Physician
  • Syracuse, NY
National Provider Identifier
1841340205
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
CROUSE HEALTH HOSPITAL INC
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7111
NPI assigned
Jan 10, 2007
Last updated
Aug 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Authorized official

Name
Kelli Harris
Title
Cfo
Phone
(315) 470-8058

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Urgent Care Clinic/Center 261QU0200X 3301008H NY
Emergency Medicine Physician 207P00000X NU
Addiction Medicine (Internal Medicine) Physician 207RA0401X NU
Pulmonary Disease Physician 207RP1001X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Surgery Physician 208600000X NU
Hospitalist Physician 208M00000X NU Primary
Pediatric Orthopaedic Surgery Physician 207XP3100X NU
Pediatric Hospice and Palliative Medicine Physician 2080H0002X NU

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

1001 W Fayette St
Ste 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Other identifiers 2

IdentifierTypeStateIssuer
00279396MedicaidNY
03130476MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000018 NY Part B Supplier - Clinic/Group Practice 9739173774 Receives reassigned benefits from 246 practitioners
1 other NPI on this enrollment
Practice locations: Syracuse, NY

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

739 Irving Ave
Syracuse, NY 13210
Phone (315) 470-2951

Practitioners & affiliated clinicians

Practitioners 321

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 321

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1841340205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-472-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROUSE HEALTH HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-470-8058"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "3301008H",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00279396",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03130476",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.