Individual provider Active NPI

Angana Mahapatra, D.O.

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1912262890
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
276703-1 Issued in NY
Practice address
725 Irving Ave Ste 311
Syracuse, NY 13210-1685
Phone
(315) 464-5815
Fax
(315) 464-9150
NPI assigned
Jul 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 276703-1 NY Primary

Addresses

Primary practice location

725 Irving Ave Ste 311
Syracuse, NY 13210-1685

Mailing address

725 Irving Ave Ste 311
Syracuse, NY 13210-1685
Phone (315) 464-5815

Other identifiers 1

IdentifierTypeStateIssuer
04193239MedicaidNY

Other names 1

  • Angana Homchaudhuri Former name

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
I20150721000634 NY Practitioner - Family Practice 9032422068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 Harrison St
Syracuse, NY 13202-3188
Phone (315) 464-8093

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-8093

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.04 of 100Reported as group
Quality
67.92
Promoting interoperability
99
Improvement activities
40
Cost
69.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276703-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Apr 2, 2024 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Dec 8, 2018 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Apr 2, 2024 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Dec 8, 2018 Accepting new patients

Locations

725 Irving Ave
Ste 311
Syracuse, NY 13210
Phone (315) 464-5533

725 E Adams St
Fl 3
Syracuse, NY 13210
Phone (315) 464-5533

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

Interoperability endpoints

  • Direct secure messaging: amahapatra85174@direct.upstate.edu

Organizations & group practices 4

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": "1341619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1912262890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 311",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101685",
            "telephone_number": "315-464-5815",
            "fax_number": "315-464-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 311",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101685",
            "telephone_number": "315-464-5815",
            "fax_number": "315-464-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAPATRA",
        "first_name": "ANGANA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-07",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "276703-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04193239",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGANA",
            "last_name": "HOMCHAUDHURI",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.