Organization Active NPI

Elite Healthcare Medical Associates

  • Orthopaedic Surgery Physician
  • Liverpool, NY
National Provider Identifier
1871867911
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ELITE HEALTHCARE MEDICAL ASSOCIATES
Practice address
8100 Oswego Rd
Suite 105
Liverpool, NY 13090-1654
Phone
(315) 701-4024
NPI assigned
Mar 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
Irving G Raphael, MD
Title
Partner
Phone
(315) 701-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X

Addresses

Primary practice location

8100 Oswego Rd
Suite 105
Liverpool, NY 13090-1654

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2856
Phone (315) 472-1488

Other identifiers 1

IdentifierTypeStateIssuer
03397082MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1871867911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042856",
            "telephone_number": "315-472-1488",
            "fax_number": "315-476-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 OSWEGO RD",
            "address_2": "SUITE 105",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901654",
            "telephone_number": "315-701-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTHCARE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "RAPHAEL",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "315-701-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03397082",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.