Individual provider Active NPI

Michael Zaccaria, MSPT

  • Physical Therapist
  • Liverpool, NY
National Provider Identifier
1952812224
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0275291 Issued in NY
Practice address
8324 Oswego Rd
Liverpool, NY 13090-1026
Phone
(315) 418-4128
Fax
(315) 622-5619
NPI assigned
Oct 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0275291 NY Primary

Addresses

Primary practice location

8324 Oswego Rd
Liverpool, NY 13090-1026

Mailing address

5823 Widewaters Pkwy
East Syracuse, NY 13057-3084
Phone (315) 418-4013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171109001511 NY Practitioner - Physical Therapist in Private Practice 0143586065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8324 Oswego Rd
Suite B
Liverpool, NY 13090-1086
Phone (315) 418-4188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0275291NYMDPhysical Therapist
027529NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Nov 1, 2017 Accepting new patients
Syracuse Orthopedic Specialists, PLLC PastSince Nov 1, 2017 Accepting new patients

Locations

5823 Widewaters Pkwy
East Syracuse, NY 13057
Phone (315) 426-0190

8324 Oswego Rd
Ste A
Liverpool, NY 13090
Phone (315) 418-4128

8324 Oswego Rd
Ste B
Liverpool, NY 13090
Phone (315) 418-4188

8324 Oswego Rd
Liverpool, NY 13090
Phone (315) 418-4128

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1952812224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573084",
            "telephone_number": "315-418-4013",
            "fax_number": "315-478-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8324 OSWEGO RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901026",
            "telephone_number": "315-418-4128",
            "fax_number": "315-622-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACCARIA",
        "first_name": "MICHAEL",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0275291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.