Individual provider Active NPI

Amber L Shutter, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Auburn, NY
National Provider Identifier
1013378827
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405030 Issued in NY
Practice address
146 North St
Auburn, NY 13021-1831
Phone
(315) 253-0341
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 688705 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405030 NY Primary

Addresses

Primary practice location

146 North St
Auburn, NY 13021-1831

Mailing address

2864 Fire Lane 1
Moravia, NY 13118-9375

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
I20231006002611 NY Practitioner - Nurse Practitioner 1759736028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Community HospitalGroup PAC ID 2365346525, 61 clinicians
St Josephs Hospital Health CenterGroup PAC ID 9234043324, 107 clinicians

Practice addresses (Care Compare)

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7142

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 703-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
688705NYMDRegistered Nurse
405030NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital Health Center CurrentSince Oct 1, 2023 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Nov 1, 2023 Accepting new patients
Auburn Community Hospital CurrentSince Nov 1, 2023 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Nov 1, 2023 Accepting new patients
St Josephs Hospital Health Center CurrentSince Oct 1, 2023 Accepting new patients
St. Joseph'S Pathology, PC Current Accepting new patients
Auburn Community Hospital CurrentSince Nov 1, 2023 Accepting new patients
St Josephs Medical PC Past Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

77 Nelson St
Ste 220
Auburn, NY 13021
Phone (315) 252-8838

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1013378827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 FIRE LANE 1",
            "city": "MORAVIA",
            "state": "NY",
            "postal_code": "131189375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 NORTH ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211831",
            "telephone_number": "315-253-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTTER",
        "first_name": "AMBER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2023-06-19",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "688705",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.