Individual provider Active NPI

Wendy Lynn Broton, NP

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1104061217
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
335618 Issued in NY
Practice address
90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Phone
(315) 464-4357
Fax
(315) 464-7564
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 335618 NY Primary

Addresses

Primary practice location

90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240

Mailing address

90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Phone (315) 464-4357

Other identifiers 1

IdentifierTypeStateIssuer
03056388MedicaidNY

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
I20130802000844 NY Practitioner - Nurse Practitioner 7113169103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.04 of 100Reported as group
Quality
67.92
Promoting interoperability
99
Improvement activities
40
Cost
69.19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Sep 22, 2018 Accepting new patients
Suny Health Science Center at Syracuse Nurse Practitioner CurrentSince Sep 22, 2018 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

725 Irving Ave
Ste 406
Syracuse, NY 13210

90 Presidential Plz
Fl 3
Syracuse, NY 13202
Phone (315) 464-4357

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: wbroton6020@direct.upstate.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1104061217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4357",
            "fax_number": "315-464-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4357",
            "fax_number": "315-464-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTON",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "335618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03056388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.