NPIMap

Organization Active NPI

Northway Medical Associates, PLLC

  • Family Medicine Physician
  • Fulton, NY
National Provider Identifier
1952493686
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHWAY MEDICAL ASSOCIATES, PLLC
Practice address
21 N 2ND St
Fulton, NY 13069-1250
Phone
(315) 598-7105
Fax
(315) 598-4857
NPI assigned
Sep 29, 2006
Last updated
Jul 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Dr. Suryakant Z Patel, M.D.NPI 1700885738
Title
Co-Owner
Phone
(315) 598-7105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

21 N 2ND St
Fulton, NY 13069-1250

Mailing address

21 N 2ND St
Fulton, NY 13069-1250
Phone (315) 598-7105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100820000004 NY Part B Supplier - Clinic/Group Practice 3577547017 Receives reassigned benefits from 12 practitioners
Practice locations: Baldwinsville, NY; Fulton, NY

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

21 N 2nd St
Fulton, NY 13069
Phone (315) 564-7085

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1952493686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N 2ND ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691250",
            "telephone_number": "315-598-7105",
            "fax_number": "315-598-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N 2ND ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691250",
            "telephone_number": "315-598-7105",
            "fax_number": "315-598-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWAY MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SURYAKANT",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "315-598-7105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.