NPIMap

Organization Active NPI

New York Anesthesiology Medical Specialties, PC

Doing business as New York Spine and Wellness Center

  • Durable Medical Equipment & Medical Supplies
  • East Syracuse, NY
National Provider Identifier
1992032429
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Doing business as
New York Spine and Wellness Center
Practice address
6711 Towpath Rd Ste 265
East Syracuse, NY 13057-9510
Phone
(315) 703-3480
Fax
(315) 703-3481
NPI assigned
Nov 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Robert Tiso, MDNPI 1942295092
Title
Director
Phone
(315) 552-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6711 Towpath Rd Ste 265
East Syracuse, NY 13057-9510

Mailing address

PO Box 510
Syracuse, NY 13214-0510
Phone (315) 703-3480

Other names 1

  • New York Spine and Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930016812 NY DME Supplier - Physician - General Practice 3375535396 Practice locations: East Syracuse, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
New York Anesthesiology Medical Specialties PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1992032429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132140510",
            "telephone_number": "315-703-3480",
            "fax_number": "315-703-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 TOWPATH RD STE 265",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579510",
            "telephone_number": "315-703-3480",
            "fax_number": "315-703-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "TISO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-552-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 21, 2021; 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.