Individual provider Active NPI

Michael L Vertino, M.D.

  • Neurology Physician
  • Syracuse, NY
National Provider Identifier
1861450694
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
215985 Issued in NY
Practice address
90 Presidential PLZ
4TH Floor
Syracuse, NY 13202-2240
Phone
(315) 464-4243
Fax
(315) 464-5350
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 215985 NY
Neurology Physician 2084N0400X 215985 NY Primary

Addresses

Primary practice location

90 Presidential PLZ
4TH Floor
Syracuse, NY 13202-2240

Mailing address

90 Presidential PLZ
4TH Floor
Syracuse, NY 13202-2240
Phone (315) 464-4243

Other practice location 1

739 Irving Ave Ste 340
Syracuse, NY 13210-1605
Phone (315) 470-7747

Other identifiers 1

IdentifierTypeStateIssuer
02153193MedicaidNY

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
I20100201000031 NY Practitioner - NeurologyPractitioner - Other (Physician) 0244244150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Medical Service Group LLPGroup PAC ID 7214928035, 39 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 464-4470

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4627

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Medical Service Group, LLP Neurology CurrentSince Jul 1, 2000 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Sep 29, 2018 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Sep 29, 2018 Accepting new patients
Crouse Health Inc. Past Accepting new patients

Locations

90 Presidential Plz
Fl 4
Syracuse, NY 13202
Phone (315) 464-4243

739 Irving Ave
Ste 340
Syracuse, NY 13210
Phone (315) 470-7747

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

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

Interoperability endpoints

  • Direct secure messaging: mvertino7172@direct.upstate.edu
  • Direct secure messaging: drvertino@amms.medentdirect.com

Organizations & group practices 4

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1861450694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4243",
            "fax_number": "315-464-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4243",
            "fax_number": "315-464-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "739 Irving Ave Ste 340",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101605",
            "country_code": "US",
            "telephone_number": "315-470-7747",
            "fax_number": "315-470-7758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERTINO",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "215985",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "215985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02153193",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.