Individual provider Active NPI

Stephanie Ann Coglitore, MSN, FNP-BC

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1003160508
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F347979-01 Issued in NY
Practice address
204 Halcomb St
Syracuse, NY 13209-1423
Phone
(315) 727-5276
NPI assigned
Nov 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9458779 FL
Registered Nurse 163W00000X 6310161 NY
Family Nurse Practitioner 363LF0000X 11011264 FL
Family Nurse Practitioner 363LF0000X F347979-01 NY Primary

Addresses

Primary practice location

204 Halcomb St
Syracuse, NY 13209-1423

Mailing address

204 Halcomb St
Syracuse, NY 13209-1423
Phone (315) 727-5276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220207002408 NY Practitioner - Nurse Practitioner 0042616138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine Associates of AuburnGroup PAC ID 2163405135, 7 clinicians

Practice addresses (Care Compare)

77 Nelson St
Suite 310
Auburn, NY 13021-1945
Phone (315) 253-4463

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.05 of 100Reported as group
Quality
97.55
Improvement activities
40
Cost
76.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
9458779FLMDRegistered Nurse
6310161NYMDRegistered Nurse
347979NYMDLicensed Practical Nurse
11011264FLMDFamily Nurse Practitioner
F347979-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Auburn CurrentSince Feb 1, 2024 Accepting new patients

Locations

77 Nelson St
Ste 310
Auburn, NY 13021
Phone (315) 253-4463

Interoperability endpoints

  • Direct secure messaging: scoglitore@imaamed.medentdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1003160508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HALCOMB ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091423",
            "telephone_number": "315-727-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HALCOMB ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091423",
            "telephone_number": "315-727-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGLITORE",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "MSN,  FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9458779",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "6310161",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011264",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347979-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.