Individual provider Active NPI

Billy Manuel, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1093293383
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402391 Issued in NY
Practice address
620 Erie Blvd W Ste 302
Syracuse, NY 13204-2463
Phone
(315) 472-7363
NPI assigned
Jul 30, 2018
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402391 NY Primary
Registered Nurse 163W00000X 684280 NY

Addresses

Primary practice location

620 Erie Blvd W Ste 302
Syracuse, NY 13204-2463

Mailing address

4396 Georgian CT Apt 27
Liverpool, NY 13090-3889
Phone (678) 428-3647

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
I20200608001377 NY Practitioner - Nurse Practitioner 2769803352 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oswego HospitalGroup PAC ID 4981686045, 59 clinicians

Practice addresses (Care Compare)

29 E Cayuga St
Suite 400
Oswego, NY 13126-1241
Phone (315) 326-3536

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
684280NYMDRegistered Nurse
402391NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Apr 18, 2022 Accepting new patients
Cayuga Counseling Services Inc CurrentSince Apr 26, 2023 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Apr 18, 2022 Accepting new patients
Family Counseling Services of Cortland County, Inc. Psychiatric/Mental Health CurrentSince Mar 3, 2025 Accepting new patients
Auburn Community Hospital CurrentSince Apr 18, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Apr 18, 2022 Accepting new patients
Psychiatric NP Services of Cny PLLC CurrentSince Jan 1, 2024 Accepting new patients
Oswego Hospital CurrentSince Apr 30, 2020 Accepting new patients

Locations

17 E Genesee St
Auburn, NY 13021
Phone (315) 253-9795

17 E Genesee St
Fl 2
Auburn, NY 13021
Phone (315) 253-9795

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

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

165 Main St
Ste A
Cortland, NY 13045

201 Cedar St
Oneida, NY 13421
Phone (315) 280-0400

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

29 E Cayuga St
Ste 400
Oswego, NY 13126
Phone (315) 326-3536

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1093293383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4396 GEORGIAN CT APT 27",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903889",
            "telephone_number": "678-428-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042463",
            "telephone_number": "315-472-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "BILLY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402391",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "684280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.