Organization Active NPI

Syracuse Gynecology PLLC

  • Gynecology Physician
  • East Syracuse, NY
National Provider Identifier
1982484861
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
SYRACUSE GYNECOLOGY PLLC
Practice address
4939 Brittonfield Pkwy Ste 211a
East Syracuse, NY 13057-9208
Phone
(315) 917-0118
NPI assigned
Sep 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Monideepa Baruah, MDNPI 1881816015
Title
Owner
Phone
(315) 917-0118

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

4939 Brittonfield Pkwy Ste 211a
East Syracuse, NY 13057-9208

Mailing address

4939 Brittonfield Pkwy Ste 211a
East Syracuse, NY 13057-9208
Phone (315) 917-0118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231208000845 NY Part B Supplier - Clinic/Group Practice 1052760618 Receives reassigned benefits from 1 practitioner
Practice locations: East Syracuse, NY

National Provider Directory

National Provider Directory

Locations

4939 Brittonfield Pkwy
Ste 211
East Syracuse, NY 13057
Phone (315) 446-4400

4939 Brittonfield Pkwy
Ste 211A
East Syracuse, NY 13057
Phone (315) 917-0118

Practitioners & affiliated clinicians

Practitioners 1

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": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1982484861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 211A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-917-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 211A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-917-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRACUSE GYNECOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-29",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "BARUAH",
        "authorized_official_first_name": "MONIDEEPA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-917-0118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.