Active NPI
Peter W Calabrese, DPM
- Podiatrist
- Syracuse, NY
National Provider Identifier
1902888142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N0030381
- Practice address
- 2105 W Genesee St
Syracuse, NY 13219-1656 - Phone
- (315) 488-6638
- Fax
- (315) 487-2815
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N0030381 | NY | Primary |
Addresses
Primary practice location
2105 W Genesee St
Syracuse, NY 13219-1656
Mailing address
2105 W Genesee St
Syracuse, NY 13219-1656
Phone (315) 488-6638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00597053 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N0030381 | NY | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1902888142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 W GENESEE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132191656",
"telephone_number": "315-488-6638",
"fax_number": "315-487-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 W GENESEE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132191656",
"telephone_number": "315-488-6638",
"fax_number": "315-487-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALABRESE",
"first_name": "PETER",
"middle_name": "W",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N0030381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00597053",
"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 Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.