AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC
NPI 1609865054
Surgery - Plastic and Reconstructive Surgery in Camillus, NY

Q: What is Aesthetic Plastic Surgery Of Syracuse PLLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Active since October 18, 2005

5700 W GENESEE ST, SUITE 132, CAMILLUS, NY 13031(315) 487-5858(315) 487-1950 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Aesthetic Plastic Surgery Of Syracuse Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC (NPI 1609865054) is a healthcare organization registered as a plastic and reconstructive surgery in Camillus, New York and active in the NPI registry since October 2005. The organization lists Mark S Potenza, Owner, as its authorized official.

NPPES Registry Identity

NPI1609865054

Entity TypeOrganization

Primary Taxonomy2086S0122X

Legal Business NameAESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC

Location Address5700 W GENESEE ST, SUITE 132Camillus, NY 13031-3200

Mailing AddressPo Box 2003East Syracuse, NY 13057-4503 · (315) 446-3904 · Fax (315) 445-2936

Phone(315) 487-5858

Fax(315) 487-1950

Organization SubpartNo

Authorized OfficialMark S PotenzaOwner · (315) 487-5858

Enumeration DateOctober 18, 2005

Last NPPES UpdateAugust 22, 2020

✔ NPI 1609865054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

Definition

A surgeon who specializes in plastic and reconstructive surgery.

5700 W GENESEE ST, Camillus, NY 13031

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aesthetic Plastic Surgery Of Syracuse Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Aesthetic Plastic Surgery Of Syracuse PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Potenza, MD

Plastic and Reconstructive Surgery

NPI 1134122096

5700 W GENESEE ST STE 132
Camillus, NY 13031

(315) 487-5858

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aesthetic Plastic Surgery Of Syracuse PLLC's NPI number?

The NPI number for Aesthetic Plastic Surgery Of Syracuse PLLC is 1609865054. It was assigned to this organization in the NPPES registry on October 18, 2005.

Where is Aesthetic Plastic Surgery Of Syracuse PLLC located?

Aesthetic Plastic Surgery Of Syracuse PLLC is located at 5700 W Genesee St Suite 132, Camillus, NY 13031. The listed phone number is (315) 487-5858.

What is Aesthetic Plastic Surgery Of Syracuse PLLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Aesthetic Plastic Surgery Of Syracuse PLLC enrolled in Medicare?

Yes. Aesthetic Plastic Surgery Of Syracuse PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aesthetic Plastic Surgery Of Syracuse PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Aesthetic Plastic Surgery Of Syracuse PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Aesthetic Plastic Surgery Of Syracuse PLLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.