Individual provider Active NPI

Karen M Cleveland, N.P.

  • Adult Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1093837940
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
301101 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 448-5440
Fax
(315) 472-5010
NPI assigned
Apr 4, 2007
Last updated
Feb 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 301101 NY Primary
Critical Care Medicine Registered Nurse 163WC0200X F301101-1 NY

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5440

Other identifiers 1

IdentifierTypeStateIssuer
02370501MedicaidNY

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
I20130523000627 NY Order and Referring Only - Nurse Practitioner 4789822164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F301101-1NYMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Syracuse, PC Past Accepting new patients

Organizations & group practices 1

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1093837940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301101",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "F301101-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02370501",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.