Active NPI
Nancy Elizabeth Mengucci, PT
- Physical Therapist
- Syracuse, NY
National Provider Identifier
1093934366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012001-1
- Practice address
- 4101 E Genesee St
Syracuse, NY 13214-2136 - Phone
- (315) 446-9111
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012001-1 | NY | Primary |
Addresses
Primary practice location
4101 E Genesee St
Syracuse, NY 13214-2136
Mailing address
115 Ferndale Rd
Syracuse, NY 13219-2337
Phone (315) 247-6420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012001 | NY | MD | Mental Health Counselor |
| 012001-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351123200000",
"number": "1093934366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 FERNDALE RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132192337",
"telephone_number": "315-247-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 E GENESEE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132142136",
"telephone_number": "315-446-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENGUCCI",
"first_name": "NANCY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2012-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012001-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.