Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kamal Prasad Gautam, MD

Individual provider Internal Medicine Physician · NPI 1992053250

Kamal Prasad Gautam, MD is an Internal Medicine in Syracuse, New York. Qualified in 2015, 11 years ago. Practices with Crouse Medical Practice PLLC, a 189-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

739 Irving Ave Ste 200
Syracuse, NY 13210-1668
Phone: (315) 479-5070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 280518 (NY)

Record details

NPI number1992053250
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 16, 2012
Last updated in NPPESAugust 2, 2023
Certification dateAugust 2, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Crouse Medical Practice Pllc — 189 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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