| Oswego Health Medical Practice | |
|
110 W 6th St Oswego NY 13126-2507 | |
| (315) 349-5511 | |
| (315) 736-2162 |
| Full Name | Oswego Health Medical Practice |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 W 6th St, Oswego, New York |
| Authorized Official Name and Position | Duane Tull (DIRECTOR) |
| Authorized Official Contact | 3153495511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oswego Health Medical Practice 110 W 6th St Oswego NY 13126-2507 Ph: (315) 349-5511 | Oswego Health Medical Practice 110 W 6th St Oswego NY 13126-2507 Ph: (315) 349-5511 |
| NPI Number | 1073868113 |
|---|---|
| Provider Enumeration Date | 07/16/2012 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Medicare PECOS PAC ID | 9032367453 |
|---|---|
| Medicare Enrollment ID | O20120910000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073868113 | NPI | - | NPPES |
| Provider Name | Carlos O Dator |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447271259 PECOS PAC ID: 7618965294 Enrollment ID: I20040505000236 |
| Provider Name | Tina a Maxian |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467457416 PECOS PAC ID: 2769471911 Enrollment ID: I20040511001562 |
| Provider Name | Norman D Jaffe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386630549 PECOS PAC ID: 6709771199 Enrollment ID: I20040524000924 |
| Provider Name | Micheal D Stephens |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1659317980 PECOS PAC ID: 7315849031 Enrollment ID: I20040528000967 |
| Provider Name | David R Downey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225140536 PECOS PAC ID: 7416939558 Enrollment ID: I20040603000129 |
| Provider Name | Surianarayanan Karthikeyan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881725836 PECOS PAC ID: 3476532771 Enrollment ID: I20040720000024 |
| Provider Name | James F Sexton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760416879 PECOS PAC ID: 8921088832 Enrollment ID: I20040721001630 |
| Provider Name | Brandon M Weaver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730220500 PECOS PAC ID: 4880667195 Enrollment ID: I20040816000665 |
| Provider Name | Jamie Lyn Masson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962404871 PECOS PAC ID: 8729055801 Enrollment ID: I20050328000922 |
| Provider Name | John H Sun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205840899 PECOS PAC ID: 7315986734 Enrollment ID: I20050426000762 |
| Provider Name | Jeffrey a Greenhouse |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790770048 PECOS PAC ID: 2567418197 Enrollment ID: I20050711000649 |
| Provider Name | Jessica M Digby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740247493 PECOS PAC ID: 4688692825 Enrollment ID: I20051107000636 |
| Provider Name | Raman Dhawan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972562155 PECOS PAC ID: 0143277566 Enrollment ID: I20051130000688 |
| Provider Name | Jeffrey M Desimone |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699726737 PECOS PAC ID: 8820019631 Enrollment ID: I20051208000288 |
| Provider Name | Taewan Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992757421 PECOS PAC ID: 0042233702 Enrollment ID: I20060109000419 |
| Provider Name | Vandana B Patil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285735027 PECOS PAC ID: 0244334845 Enrollment ID: I20070409000048 |
| Provider Name | Douglas Guenter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659450989 PECOS PAC ID: 5294826293 Enrollment ID: I20070806000394 |
| Provider Name | Kenneth a Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518166289 PECOS PAC ID: 7214021286 Enrollment ID: I20070921000041 |
| Provider Name | Thomas a Grady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962400754 PECOS PAC ID: 2860387065 Enrollment ID: I20080428000202 |
| Provider Name | Melinda M Shaw |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619914942 PECOS PAC ID: 5395892228 Enrollment ID: I20090413000164 |
| Provider Name | Gary D Stoltz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528249513 PECOS PAC ID: 2062562770 Enrollment ID: I20090617000630 |
| Provider Name | Amar C Suryadevara |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1255599494 PECOS PAC ID: 9638242142 Enrollment ID: I20090623000397 |
| Provider Name | Michael R Diaz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780646216 PECOS PAC ID: 2466595145 Enrollment ID: I20100203000270 |
| Provider Name | Ajoy K Roy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487633400 PECOS PAC ID: 8628037587 Enrollment ID: I20100315000655 |
| Provider Name | Rayees Nizam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154375087 PECOS PAC ID: 4082664537 Enrollment ID: I20100512000773 |
| Provider Name | Mark a Humphrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831126648 PECOS PAC ID: 4880785807 Enrollment ID: I20100804000274 |
| Provider Name | Carrie E Marlow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215241294 PECOS PAC ID: 1456545425 Enrollment ID: I20101103000943 |
| Provider Name | Scott a Edison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124032032 PECOS PAC ID: 1052507001 Enrollment ID: I20101202000329 |
| Provider Name | Bobbie Rae Vangorder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154630366 PECOS PAC ID: 2567642457 Enrollment ID: I20110209001023 |
| Provider Name | Michael Dinkels |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043457674 PECOS PAC ID: 1557544756 Enrollment ID: I20110325000282 |
| Provider Name | Joan Newell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487829503 PECOS PAC ID: 0042489817 Enrollment ID: I20110811000728 |
| Provider Name | Maria T Iannolo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093954406 PECOS PAC ID: 3870763055 Enrollment ID: I20110825000336 |
| Provider Name | Bradley S Raphael |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295992303 PECOS PAC ID: 8628100997 Enrollment ID: I20110830000305 |
| Provider Name | Girish Trikha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437360690 PECOS PAC ID: 3870768526 Enrollment ID: I20111208000584 |
| Provider Name | Colleen M Krug |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578895652 PECOS PAC ID: 7618007188 Enrollment ID: I20120426000004 |
| Provider Name | Will H Stilwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407102734 PECOS PAC ID: 7517115447 Enrollment ID: I20120918000273 |
| Provider Name | Thomas C Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568652261 PECOS PAC ID: 0749445591 Enrollment ID: I20130730000510 |
| Provider Name | Melanie Groch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619979374 PECOS PAC ID: 9234161647 Enrollment ID: I20130909000778 |
| Provider Name | Nicholas Groch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1922031004 PECOS PAC ID: 1052314994 Enrollment ID: I20130927000059 |
| Provider Name | Colin Coniski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073942611 PECOS PAC ID: 8123258902 Enrollment ID: I20140221001007 |
| Provider Name | Ryan M Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558568170 PECOS PAC ID: 3173740909 Enrollment ID: I20140819000034 |
| Provider Name | Jesse T Ryan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1285792143 PECOS PAC ID: 4284800483 Enrollment ID: I20150730012675 |
| Provider Name | Peter Lacell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1225484140 PECOS PAC ID: 4284927393 Enrollment ID: I20160727001765 |
| Provider Name | Joselito Ouano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831152578 PECOS PAC ID: 2860464690 Enrollment ID: I20160819001133 |
| Provider Name | Robert a Ogg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134197312 PECOS PAC ID: 6709978620 Enrollment ID: I20160916002045 |
| Provider Name | Lisa M Lai |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1003135310 PECOS PAC ID: 7416268982 Enrollment ID: I20161003000154 |
| Provider Name | Emily Megan Crandell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114476231 PECOS PAC ID: 4880974427 Enrollment ID: I20161216001788 |
| Provider Name | Rahul Shinde |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619416203 PECOS PAC ID: 3870879489 Enrollment ID: I20170414000304 |
| Provider Name | Sergey Kravchick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548789662 PECOS PAC ID: 4688931702 Enrollment ID: I20171128002138 |
| Provider Name | David Bass |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497045900 PECOS PAC ID: 0244457752 Enrollment ID: I20180730003326 |
| Provider Name | Justin Raymond Beebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285128314 PECOS PAC ID: 5799034054 Enrollment ID: I20180820001551 |
| Provider Name | Nitin Verma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598872731 PECOS PAC ID: 2264439256 Enrollment ID: I20181114002767 |
| Provider Name | Jon Robert Vanderweele |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1598737801 PECOS PAC ID: 8729332556 Enrollment ID: I20181114002955 |
| Provider Name | Michael D Carey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922587963 PECOS PAC ID: 9830443274 Enrollment ID: I20181121000502 |
| Provider Name | Deirdre Wahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700366192 PECOS PAC ID: 9537404116 Enrollment ID: I20181231001825 |
| Provider Name | Duane F Tull |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225073976 PECOS PAC ID: 1951307644 Enrollment ID: I20190112000058 |
| Provider Name | Andrew Rogall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689025710 PECOS PAC ID: 9133414139 Enrollment ID: I20191025000970 |
| Provider Name | Meaghan Primm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992259451 PECOS PAC ID: 2163701343 Enrollment ID: I20191029002243 |
| Provider Name | Mohammad Fahad Ali |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710248471 PECOS PAC ID: 5092148932 Enrollment ID: I20191206000082 |
| Provider Name | Ruth Vasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629696224 PECOS PAC ID: 2264842277 Enrollment ID: I20201103001498 |
| Provider Name | Samantha Blais |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578217972 PECOS PAC ID: 5991190571 Enrollment ID: I20220317000792 |
| Provider Name | Samantha Goutermout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114657228 PECOS PAC ID: 7618350893 Enrollment ID: I20220822000854 |
| Provider Name | Jill Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396463725 PECOS PAC ID: 0244616043 Enrollment ID: I20221003000312 |
| Provider Name | Ruth Mary Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346960556 PECOS PAC ID: 3476921628 Enrollment ID: I20221121000806 |
| Provider Name | Johna Faye Halko |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184339293 PECOS PAC ID: 1052784683 Enrollment ID: I20230302000660 |
| Provider Name | Shawnna Ann Nye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588392930 PECOS PAC ID: 2264806777 Enrollment ID: I20230324000870 |
| Provider Name | Hannah Grace Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659081297 PECOS PAC ID: 8527424647 Enrollment ID: I20230516002030 |
| Provider Name | Jeffrey Alan Dorrity |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336584630 PECOS PAC ID: 1052615259 Enrollment ID: I20230714000752 |
| Provider Name | Kiranya E Arnold |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265964639 PECOS PAC ID: 7012253685 Enrollment ID: I20230731001089 |
| Provider Name | Eyal Kord |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316612609 PECOS PAC ID: 8224426580 Enrollment ID: I20231012001127 |
| Provider Name | Katelyn Lashell Quehl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932987732 PECOS PAC ID: 2961859236 Enrollment ID: I20231108000445 |
| Provider Name | Helen Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689452617 PECOS PAC ID: 1153778337 Enrollment ID: I20231109000911 |
| Provider Name | Kimberly Pompo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568144780 PECOS PAC ID: 5092163550 Enrollment ID: I20231122002260 |
| Provider Name | Sharon Ann Snover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972663417 PECOS PAC ID: 5193176303 Enrollment ID: I20240111002364 |
| Provider Name | Jamie Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104608595 PECOS PAC ID: 2264879790 Enrollment ID: I20240320001464 |
| Provider Name | Michael John Danise |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508395195 PECOS PAC ID: 8426327982 Enrollment ID: I20240829004608 |
| Provider Name | Ravneet Kaur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477124113 PECOS PAC ID: 7113322793 Enrollment ID: I20240923003184 |
| Provider Name | Jessie Anne Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891527065 PECOS PAC ID: 3870026503 Enrollment ID: I20241101001699 |
| Provider Name | Erika Ruggieri |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386468460 PECOS PAC ID: 3173050580 Enrollment ID: I20241226000721 |
| Provider Name | Zachary Revette |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437856002 PECOS PAC ID: 8527596030 Enrollment ID: I20250113000512 |
| Provider Name | Rohini Chatterjee |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134504699 PECOS PAC ID: 7810239084 Enrollment ID: I20250617001036 |
| Provider Name | Rachel Kearl |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174085583 PECOS PAC ID: 6103332531 Enrollment ID: I20250722002821 |
| Provider Name | Jacob S Mesches |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568084531 PECOS PAC ID: 0143726810 Enrollment ID: I20251001002760 |
| Provider Name | Christine Ma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538806203 PECOS PAC ID: 6709261977 Enrollment ID: I20251106000159 |
| Provider Name | Casey Owen Donovan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326919424 PECOS PAC ID: 0244723153 Enrollment ID: I20251201000017 |
| Provider Name | Sarita Lamichhane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942191192 PECOS PAC ID: 8921592841 Enrollment ID: I20251209001866 |
| Provider Name | Michelle Antonette Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225864531 PECOS PAC ID: 7416430400 Enrollment ID: I20260309000267 |
Flourish Beauty and Spa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 4th Ave, Oswego, NY 13126 Phone: 315-207-2023 |
Lake Ontario Prompt Medical Care, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 State Route 104 Ste 2, Oswego, NY 13126 Phone: 315-216-4036 Fax: 315-216-4560 |
Endocrine Associate of Oswego PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 West Utica Street Suite A, Oswego, NY 13126 Phone: 315-216-4871 Fax: 888-827-9682 |
Hometown House Calls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 249a Washington Blvd., Oswego, NY 13126 Phone: 315-297-3896 |
Ontario Lakeside Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 90 W Utica St, Oswego, NY 13126 Phone: 315-342-8552 Fax: 315-342-8572 |
Oswego Medical Consultants PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-342-4768 |