Individual provider Active NPI

David R Hootnick, MD

  • Orthopaedic Surgery Physician
  • Liverpool, NY
National Provider Identifier
1912969239
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
128072 Issued in NY
Practice address
7449 Morgan Road
Avon Office Park
Liverpool, NY 13090-3501
Phone
(315) 451-5400
Fax
(315) 451-5422
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 128072 NY Primary

Addresses

Primary practice location

7449 Morgan Road
Avon Office Park
Liverpool, NY 13090-3501

Mailing address

7449 Morgan Road
Avon Office Park
Liverpool, NY 13090-3501
Phone (315) 451-5400

Other identifiers 1

IdentifierTypeStateIssuer
00524534MedicaidNY

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
I20060410000500 NY Practitioner - Orthopedic Surgery 8123037728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128072NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC Orthopaedic Surgery Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1912969239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7449 MORGAN ROAD",
            "address_2": "AVON OFFICE PARK",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903501",
            "telephone_number": "315-451-5400",
            "fax_number": "315-451-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7449 MORGAN ROAD",
            "address_2": "AVON OFFICE PARK",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903501",
            "telephone_number": "315-451-5400",
            "fax_number": "315-451-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOTNICK",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "128072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00524534",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.