Organization Active NPI

Michael J Paciorek MD PC

  • Otolaryngology Physician
  • Syracuse, NY
National Provider Identifier
1952497026
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
198702 Issued in NY
Legal business name
MICHAEL J PACIOREK MD PC
Practice address
Broad Rd South 2D
Community General Hospital Pob
Syracuse, NY 13215
Phone
(315) 492-5755
Fax
(315) 492-5246
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Authorized official

Name
Michael J Paciorek, MDNPI 1588750814
Title
President
Phone
(315) 492-5755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 198702 NY Primary

Addresses

Primary practice location

Broad Rd South 2D
Community General Hospital Pob
Syracuse, NY 13215

Mailing address

PO Box 4738
Syracuse, NY 13221-4738
Phone (315) 464-2237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050207000675 NY Part B Supplier - Clinic/Group Practice 0648221671 Receives reassigned benefits from 5 practitioners
Practice locations: Skaneateles, NY; Syracuse, NY

National Provider Directory

National Provider Directory

Locations

37 W Garden St
Ste 109
Auburn, NY 13021
Phone (315) 255-0606

37 W Garden St
Ste 104
Auburn, NY 13021
Phone (315) 255-0606

764 W Genesee Street Rd
Skaneateles, NY 13152
Phone (315) 685-1691

4900 Broad Rd
#2D
Syracuse, NY 13215

4900 Broad Rd
Ste 2D
Syracuse, NY 13215
Phone (315) 255-0606

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1952497026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4738",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132214738",
            "telephone_number": "315-464-2237",
            "fax_number": "315-464-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROAD RD SOUTH 2D",
            "address_2": "COMMUNITY GENERAL HOSPITAL POB",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13215",
            "telephone_number": "315-492-5755",
            "fax_number": "315-492-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J PACIOREK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "PACIOREK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-492-5755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "198702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.