Individual provider Active NPI

Stephen D Nash, M.D.

  • Cardiovascular Disease Physician
  • Syracuse, NY
National Provider Identifier
1962427013
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
172971 Issued in NY
Practice address
600 E Genesee St
Presidential Plaza, Suite 204
Syracuse, NY 13202-3130
Phone
(315) 475-9921
Fax
(315) 472-7103
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 172971 NY Primary

Addresses

Primary practice location

600 E Genesee St
Presidential Plaza, Suite 204
Syracuse, NY 13202-3130

Mailing address

600 E Genesee St
Presidential Plaza, Suite 204
Syracuse, NY 13202-3130
Phone (315) 475-9921

Other identifiers 2

IdentifierTypeStateIssuer
01190243MedicaidNY
52111BOtherNYMEDICARE PROVIDER

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
I20040126000272 NY Practitioner - Cardiovascular Disease (Cardiology) 9335041714 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
172971NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center CurrentSince Oct 1, 2017 Accepting new patients
St Josephs Medical PC CurrentSince Feb 27, 2021 Accepting new patients
St Joseph'S Hospital Health Center CurrentSince Oct 1, 2017 Accepting new patients
David T. Nash, M.D. P.C. Cardiovascular Disease PastSince Jan 1, 1990 Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

7246 Janus Park Dr
#101
Liverpool, NY 13088
Phone (315) 458-7171

7246 Janus Park Dr
Liverpool, NY 13088
Phone (315) 458-2800

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1962427013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "PRESIDENTIAL PLAZA, SUITE 204",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-475-9921",
            "fax_number": "315-472-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "PRESIDENTIAL PLAZA, SUITE 204",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-475-9921",
            "fax_number": "315-472-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "172971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01190243",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "52111B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.