Individual provider Active NPI

Michael Patrick Vannostrand, MS

  • Clinical Exercise Physiologist
  • Syracuse, NY
National Provider Identifier
1952811333
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
Practice address
505 Irving Ave
Syracuse, NY 13210-1718
Phone
(315) 464-9966
NPI assigned
Oct 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X Primary

Addresses

Primary practice location

505 Irving Ave
Syracuse, NY 13210-1718

Mailing address

104 Candlewood GDNS
Baldwinsville, NY 13027-2646
Phone (518) 332-5752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1952811333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CANDLEWOOD GDNS",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272646",
            "telephone_number": "518-332-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101718",
            "telephone_number": "315-464-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNOSTRAND",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "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 Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.