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LOUIS PELLEGRINO MD
NPI 1619924354
Pediatrics - Neurodevelopmental Disabilities in Syracuse, NY

Active since May 28, 2006PECOS Enrolled
725 IRVING AVE, CROUSE POB, SYRACUSE, NY 13210(315) 464-6395(315) 464-7564 Get Directions Write a Review

NPPES record last updated: August 27, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Louis Pellegrino Md NPPES

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

LOUIS PELLEGRINO MD (NPI 1619924354) is an individual neurodevelopmental disabilities provider in Syracuse, New York, licensed in New York (185838) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619924354
Entity TypeIndividualMale
Primary Taxonomy2080P0008X
Provider Legal NameLOUIS PELLEGRINOCredential: MD
Location Address725 IRVING AVE, CROUSE POBSyracuse, NY 13210-1603
Mailing Address725 Irving Ave, Crouse PobSyracuse, NY 13210-1603 · (315) 464-6395 · Fax (315) 464-7564
Phone(315) 464-6395
Fax(315) 464-7564
Sole ProprietorNo
Enumeration DateMay 28, 2006
Last NPPES UpdateAugust 27, 2013
✔ NPI 1619924354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neurodevelopmental DisabilitiesAllopathic & Osteopathic Physicians
Taxonomy Code2080P0008X
License✔ Licensed in NY · 185838
Definition
A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.
725 IRVING AVE, Syracuse, NY 13210
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINF55548NY
Medicaid01404291NY
Medicare PINRA4750NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Louis Pellegrino Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Louis Pellegrino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pediatric Service Group
0.3 mi
Pediatrics
750 E. ADAMS ST., 5TH FLOOR
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 131 clinicians in this Medicare group
NPI 1770539066 (315) 464-5450

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FARUK OKTEM
Pediatrics (Pediatric Nephrology)
725 IRVING AVE, STE 805
SYRACUSE, NY 13210
Onondaga County (315) 464-6340
LAWRENCE S CHIN M.D.
Neurological Surgery
725 IRVING AVE, STE. 503
SYRACUSE, NY 13210
Onondaga County (315) 464-4470
LEAH KAUFMAN MD
Obstetrics & Gynecology
725 IRVING AVE, STE 600
SYRACUSE, NY 13210
Onondaga County (315) 464-5162
NIENKE PRINS DOSA MD
Pediatrics (Neurodevelopmental Disabilities)
725 IRVING AVE, CROUSE POB
SYRACUSE, NY 13210
Onondaga County (315) 464-4842
LAWRENCE RAYMOND SHOEMAKER MD
Pediatrics (Pediatric Nephrology)
725 IRVING AVE
SYRACUSE, NY 13210
Onondaga County (315) 464-6340
SUHAS V. PRADHAN M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
725 IRVING AVE, STE 514
SYRACUSE, NY 13210
Onondaga County (315) 475-8409
EMMA ELIZABETH PATELLO MD
Obstetrics & Gynecology
725 IRVING AVE, STE 600
SYRACUSE, NY 13210
Onondaga County (315) 464-5162
DAVID P PAAR MD
Internal Medicine (Infectious Disease)
725 IRVING AVE, STE 311
SYRACUSE, NY 13210
Onondaga County (315) 464-5533

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 Louis Pellegrino's NPI number?

The NPI number for Louis Pellegrino is 1619924354. It was assigned to this individual provider in the NPPES registry on May 28, 2006.

Where is Louis Pellegrino located?

Louis Pellegrino practices at 725 Irving Ave Crouse Pob, Syracuse, NY 13210. The listed phone number is (315) 464-6395.

What is Louis Pellegrino's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neurodevelopmental Disabilities, with taxonomy code 2080P0008X.

Is Louis Pellegrino enrolled in Medicare?

Yes. Louis Pellegrino is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Louis Pellegrino's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Louis Pellegrino reassigns Medicare benefits to Pediatric Service Group (Syracuse, NY). The 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 Louis Pellegrino's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Louis Pellegrino was last updated on August 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.