NPIMap

Organization Active NPI

On Care Family Health NP, PLLC

  • Nurse Practitioner
  • Manlius, NY
National Provider Identifier
1043981814
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ON CARE FAMILY HEALTH NP, PLLC
Practice address
4591 Stoneledge LN
Manlius, NY 13104-2375
Phone
(315) 256-1249
Fax
(315) 949-2046
NPI assigned
Sep 22, 2021
Last updated
Sep 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Authorized official

Name
Marissa Vartak, NPNPI 1821537945
Title
Owner
Phone
(315) 256-1249

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

4591 Stoneledge LN
Manlius, NY 13104-2375

Mailing address

4591 Stoneledge LN
Manlius, NY 13104-2375
Phone (315) 256-1249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211006000504 NY Part B Supplier - Clinic/Group Practice 9931507969 Receives reassigned benefits from 6 practitioners
Practice locations: Cicero, NY

National Provider Directory

National Provider Directory

Locations

5972 State Route 31
Cicero, NY 13039
Phone (315) 698-4888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24958/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1043981814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4591 STONELEDGE LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042375",
            "telephone_number": "315-256-1249",
            "fax_number": "315-949-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4591 STONELEDGE LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042375",
            "telephone_number": "315-256-1249",
            "fax_number": "315-949-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON CARE FAMILY HEALTH NP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "VARTAK",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-256-1249",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.