Individual provider Active NPI

Philip T Ondocin, M.D.

  • Nephrology Physician
  • Syracuse, NY
National Provider Identifier
1902888506
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
209513 Issued in NY
Practice address
1304 Buckley Rd
Syracuse, NY 13212-4302
Phone
(315) 478-3311
Fax
(315) 426-0796
NPI assigned
Nov 18, 2005
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 209513 NY Primary

Addresses

Primary practice location

1304 Buckley Rd
Syracuse, NY 13212-4302

Mailing address

1304 Buckley Rd
Syracuse, NY 13212-4302
Phone (315) 478-3311

Other identifiers 2

IdentifierTypeStateIssuer
000136409OtherNYEXCELLLUS PROVIDER NUMBER
02228839MedicaidNY

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
I20040713001105 NY Practitioner - Nephrology 0446238547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Syracuse, P.C.Group PAC ID 2769379015, 13 clinicians

Practice addresses (Care Compare)

1304 Buckley Rd
Syracuse, NY 13212-4311

1304 Buckley Rd
Suite 200
Syracuse, NY 13212-4317
Phone (315) 478-3311

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Syracuse, P.C. Nephrology CurrentSince Jul 1, 2002 Accepting new patients
Central New York DC, LLC PastSince Apr 30, 2003 Accepting new patients

Locations

1304 Buckley Rd
Syracuse, NY 13212
Phone (315) 478-3311

1304 Buckley Rd
Ste 200
Syracuse, NY 13212
Phone (315) 478-3311

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

721 E Genesee St
Syracuse, NY 13210
Phone (315) 478-3311

Interoperability endpoints

  • Direct secure messaging: pondocin@hiemail.healtheconnections.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1902888506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124302",
            "telephone_number": "315-478-3311",
            "fax_number": "315-426-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124302",
            "telephone_number": "315-478-3311",
            "fax_number": "315-426-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDOCIN",
        "first_name": "PHILIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "209513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLLUS PROVIDER NUMBER",
            "identifier": "000136409",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02228839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.