Active NPI
Paul E Phillips, MD
- Rheumatology Physician
- Syracuse, NY
National Provider Identifier
1982629887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 096367
- Practice address
- 90 Presidential PLZ
Syracuse, NY 13202-2240 - Phone
- (315) 464-3836
- Fax
- (315) 464-3837
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 096367 | NY | |
| Rheumatology Physician | 207RR0500X | 096367 | NY | Primary |
Addresses
Primary practice location
90 Presidential PLZ
Syracuse, NY 13202-2240
Mailing address
90 Presidential PLZ
Syracuse, NY 13202-2240
Phone (315) 464-3836
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00608186 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096367 | NY | MD | Internal Medicine Physician |
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": "1276646400000",
"number": "1982629887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240",
"telephone_number": "315-464-3836",
"fax_number": "315-464-3837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240",
"telephone_number": "315-464-3836",
"fax_number": "315-464-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "PAUL",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "096367",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NY",
"license": "096367",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00608186",
"state": "NY"
}
],
"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 Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.