Individual provider Active NPI

Mary J Cunningham, MD

  • Gynecologic Oncology Physician
  • Syracuse, NY
National Provider Identifier
1902902760
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
185656 Issued in NY
Practice address
475 Irving Ave Ste 204
Syracuse, NY 13210-1529
Phone
(315) 634-4112
Fax
(315) 634-4117
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 185656 NY Primary

Addresses

Primary practice location

475 Irving Ave Ste 204
Syracuse, NY 13210-1529

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Other practice location 1

5008 Brittonfield Pkwy
Suite 400
East Syracuse, NY 13057-9248
Phone (315) 634-4112

Other identifiers 1

IdentifierTypeStateIssuer
01274419MedicaidNY

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
I20050922000566 NY Practitioner - Obstetrics/GynecologyPractitioner - Medical OncologyPractitioner - Gynecological Oncology 6103850847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Medical Oncology
Education
Northwestern University Feinberg Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University OB/GYN AssociatesGroup PAC ID 9133117740, 36 clinicians

Practice addresses (Care Compare)

725 Irving Ave
Suite 600
Syracuse, NY 13210-1688
Phone (315) 464-5162

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.06 of 100Reported as group
Quality
96.61
Promoting interoperability
100
Improvement activities
40
Cost
31.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185656NYMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University OB/GYN Associates CurrentSince Apr 2, 2012 Accepting new patients
Crouse Health Hospital, Inc. Past Accepting new patients

Locations

475 Irving Ave
Ste 204
Syracuse, NY 13210
Phone (315) 634-4112

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

Interoperability endpoints

  • Direct secure messaging: mcunningham12045@direct.upstate.edu

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 5

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1902902760",
    "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": "132042859",
            "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": "475 IRVING AVE STE 204",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101529",
            "telephone_number": "315-634-4112",
            "fax_number": "315-634-4117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5008 Brittonfield Pkwy",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "East Syracuse",
            "state": "NY",
            "postal_code": "130579248",
            "country_code": "US",
            "telephone_number": "315-634-4112",
            "fax_number": "315-634-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NY",
            "license": "185656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274419",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.