NPIMap

Individual provider Active NPI

Nelson Sofoluke, MD

  • Neurological Surgery Physician
  • Syracuse, NY
National Provider Identifier
1962938092
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
100906 Issued in GA
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-6361
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 100906 GA Primary
Neurological Surgery Physician 207T00000X MT214685 PA

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-6361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731003898 GA Practitioner - Neurosurgery 5496292096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion13
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100906GAMDNeurological Surgery Physician
MT214685PAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Single Specialty CurrentSince Jul 18, 2024 Accepting new patients
Emory Medical Care Foundation Inc Single Specialty Current Accepting new patients
The Emory Clinic Inc Single Specialty CurrentSince Jul 18, 2024 Accepting new patients
Emory Medical Care Foundation Inc Single Specialty CurrentSince Jul 18, 2024 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2665 N Decatur Rd
Decatur, GA 30033
Phone (404) 299-2223

Interoperability endpoints

  • Direct secure messaging: nsofoluke915957@direct.emory.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1962938092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFOLUKE",
        "first_name": "NELSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "100906",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MT214685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.