Individual provider Active NPI

Peter J Mariani, MD

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Syracuse, NY
National Provider Identifier
1891752408
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
License
171271 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-4363
Fax
(315) 464-8690
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 171271 NY Primary
Emergency Medicine Physician 207P00000X 171271 NY

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Emergency Medicine
Syracuse, NY 13210-2306
Phone (315) 464-4363

Other identifiers 1

IdentifierTypeStateIssuer
01041092MedicaidNY

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
I20100113000085 NY Practitioner - Emergency Medicine 2860533817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Rochester School of Medicine and Dentistry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pons Physician Services PLLCGroup PAC ID 9931416187, 15 clinicians

Practice addresses (Care Compare)

267 Hill Rd
Rome, NY 13441-4148
Phone (315) 338-7540

4005 W Rd
Route 281
Cortland, NY 13045-1843
Phone (607) 753-0993

Hospital & facility affiliations

  • Guthrie Cortland Regional Medical Center Hospital, Cortland, NY, CCN 330175

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171271NYMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pons Physician Services, PLLC Emergency Medicine CurrentSince Jun 20, 2016 Accepting new patients
Upstate Emergency Medicine, Inc Emergency Medicine CurrentSince Aug 1, 1996 Accepting new patients

Locations

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

4005 West Rd
#281
Cortland, NY 13045
Phone (607) 753-0993

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

267 Avery Ln
Ste 200
Rome, NY 13441
Phone (315) 338-7540

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

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

Interoperability endpoints

  • Direct secure messaging: pmariani139890@direct-guthrie.org
  • Direct secure messaging: pmariani@direct-address.org

Organizations & group practices 2

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1891752408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "EMERGENCY MEDICINE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANI",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NY",
            "license": "171271",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "171271",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01041092",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.