KAMAL PRASAD GAUTAM MD
NPI 1992053250
Internal Medicine in Syracuse, NY

Q: What is Kamal Gautam's NPI number?

The NPI number for Kamal Gautam is 1992053250. It was assigned to this individual provider in the NPPES registry on August 16, 2012.

Q: What is Kamal Gautam's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Kamal Gautam was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since August 16, 2012PECOS EnrolledAccepts Medicare Assignment

739 IRVING AVE STE 200, SYRACUSE, NY 13210(315) 479-5070 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 17, 2022, Jul 21, 2022, Jul 29, 2019 and 2 more (5 updates tracked since 2017).

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About Kamal Prasad Gautam Md NPPES

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

KAMAL PRASAD GAUTAM MD (NPI 1992053250) is an individual internal medicine provider in Syracuse, New York, licensed in New York (280518) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS, is affiliated with Crouse Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1992053250

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameKAMAL PRASAD GAUTAMCredential: MD

Location Address739 IRVING AVE STE 200Syracuse, NY 13210-1668

Mailing Address1001 W Fayette St Ste 400Syracuse, NY 13204-2866 · (315) 937-3433

Phone(315) 479-5070

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 16, 2012

Last NPPES UpdateAugust 2, 20235 updates tracked since enumeration

NPPES CertifiedAugust 2, 2023

✔ NPI 1992053250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NY · 280518

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

739 IRVING AVE STE 200, Syracuse, NY 13210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kamal Prasad Gautam Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890005557

PECOS Enrollment IDI20151109001095

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

91 services47 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

24 services24 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Crouse Hospital

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330203

Location736 Irving AvenueSyracuse, NY 13210 · Onondaga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$14.89 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier12 claims12 services$2.35 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$67.60 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

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

MRS. MACKENZIE RENEE ROTELLA NP-C

Nurse Practitioner (Primary Care)