Individual provider Active NPI

Hannah Joan Walsh, FNP-C

  • Family Nurse Practitioner
  • Fayetteville, NY
National Provider Identifier
1033819875
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F350405 Issued in NY
Practice address
4101 Medical Center Dr
Fayetteville, NY 13066-6600
Phone
(315) 637-7878
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F350405 NY Primary

Addresses

Primary practice location

4101 Medical Center Dr
Fayetteville, NY 13066-6600

Mailing address

447 Delwood Dr
Baldwinsville, NY 13027-3386
Phone (585) 208-1272

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
I20230523002026 NY Practitioner - Nurse Practitioner 6305202011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

4101 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

4103 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1500

4117 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1551

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F350405NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients
St Josephs Medical PC CurrentSince Jun 13, 2023 Accepting new patients
Nephrology Associates of Syracuse, P.C. Past Accepting new patients

Locations

4101 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 637-7878

4000 Medical Center Dr
Ste 101C
Fayetteville, NY 13066

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

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

Interoperability endpoints

  • Direct secure messaging: hwalsh2384211@direct.trinity-health.org

Organizations & group practices 3

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": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1033819875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 DELWOOD DR",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130273386",
            "telephone_number": "585-208-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "HANNAH",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F350405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.