Active NPI
Elite Healthcare Medical Associates
- Orthopaedic Surgery Physician
- Liverpool, NY
National Provider Identifier
1871867911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary | ||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03397082 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI 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.