Kamal Prasad Gautam, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

280518 Issued in NY

Practice address

739 Irving Ave Ste 200
Syracuse, NY 13210-1668

Phone

(315) 479-5070

NPI assigned

Aug 16, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nascentia Health at Home Home health agency, Syracuse, NY, CCN 337052
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Crouse Medical Practice, PLLC

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1922321934
  Medicare reassignment Care Compare group NPD
• Ted J. Triana, DO PC

  • Family Medicine Physician
  • Syracuse, NY
  • NPI 1992243687

  Internal Medicine

  Medicare reassignment NPD
• Crouse Medical Practice PLLC

  • Physician Assistant
  • East Syracuse, NY
  • NPI 1386990638
  NPD
• Ted J. Triana, DO, PC

  • Family Medicine Physician
  • Syracuse, NY
  • NPI 1740388651
  NPD
• Crouse Medical Practice PLLC

  • Clinical Medical Laboratory
  • Syracuse, NY
  • NPI 1548579212
  NPD (past)

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

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• Visiting Nurse Association of Central New York, Inc.

  • Home Health Agency
  • Syracuse, NY
  • NPI 1265437982
  Care Compare affiliation

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1992053250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101668",
            "telephone_number": "315-479-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "KAMAL",
        "middle_name": "PRASAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-16",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kamal.gautam@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave; Wilson Building",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgautam@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kgautam@crousemed.medentdirect.com",
            "address_1": "739 Irving Ave Ste 200",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yung-Tian Anjolie Gau, MD, PHD
• Kimberly Gaube, FNP
• Jeffrey Alan Gaulrapp, CRNA
• Asmita Gautam, MD
• Kamal Gautam
• Keshav Mani Gautam
• Christina Marie Gauthier, PT
• Kevin Gauthier, PA-C
• Taylor Alexis Gauthier
• Rebecca Gavett, PHD

• Internal Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.