Individual provider Active NPI

Ashley Elizabeth Crumb, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1104279215
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F344477-1 Issued in NY
Practice address
900 S Geddes St
Syracuse, NY 13204-3837
Phone
(315) 572-1663
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 683370 NY
Family Nurse Practitioner 363LF0000X F344477-1 NY Primary

Addresses

Primary practice location

900 S Geddes St
Syracuse, NY 13204-3837

Mailing address

930 S Salina St
Syracuse, NY 13202-3530
Phone (315) 453-4453

Other practice location 1

930 S Salina St
Syracuse, NY 13202-3530
Phone (315) 476-7921

Other identifiers 3

IdentifierTypeStateIssuer
683370-1OtherNYTHE UNIVERSITY OF THE STATE OF NY EDUCATION DEPT
1104279215MedicaidNY
363LF0000XMedicaidNY

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
I20191014002233 NY Practitioner - Nurse Practitioner 5395076822 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
683370NYMDMedical-Surgical Registered Nurse
344477NYMDDermatology Physician
F344477-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Community Health Center, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Syracuse Community Health Center CurrentSince Aug 14, 2023 Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Aug 18, 2019 Accepting new patients

Locations

8278 Willett Pkwy
Fl 2
Baldwinsville, NY 13027
Phone (315) 652-1325

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

819 S Salina St
Syracuse, NY 13202

930 S Salina St
Syracuse, NY 13202
Phone (315) 234-5960

900 S Geddes St
Syracuse, NY 13204
Phone (315) 435-6256

Interoperability endpoints

  • Direct secure messaging: ashley.crumb.p1@direct.schcny.nextgenshare.com
  • Direct secure messaging: acrumb686009@direct.ochin.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1104279215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023530",
            "telephone_number": "315-453-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S GEDDES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132043837",
            "telephone_number": "315-572-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 S Salina St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132023530",
            "country_code": "US",
            "telephone_number": "315-476-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMB",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "683370",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344477-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE UNIVERSITY OF THE STATE OF NY EDUCATION DEPT",
            "identifier": "683370-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104279215",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363LF0000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.