Keli A Evans

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F353386-01 Issued in NY

Practice address

4939 Brittonfield Pkwy Ste 202
East Syracuse, NY 13057-9208

Phone

(315) 634-6699

Fax

(315) 703-1921

NPI assigned

Mar 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Oswego Hospital Hospital, Oswego, NY, CCN 330218
• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevans2385866@direct.trinity-health.org

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.

• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment Care Compare group NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD

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

• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1013776863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 FITZPATRICK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883650",
            "telephone_number": "315-546-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 202",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-634-6699",
            "fax_number": "315-703-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KELI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353386-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empire Dermatology PLLC
• Barbara J Englehart
• Caroline Epperson
• Donal Matthew Erickson, DPM
• Erika Marie Hegland DO PC
• Kyla Elizabeth Evans, OT
• Kyle Christopher Evans, DPT
• Tricia A Eveleigh, NP
• Karen Marie Evertz, OTR/L
• Judith Hunter Fager, PHD, RN, PMHNP

• Family Nurse Practitioner in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.