Individual provider Active NPI

Deborah L. Schu, RNNP

  • Adult Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1104822675
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300287 Issued in NY
Practice address
2949 Erie Blvd E
Suite 110
Syracuse, NY 13224-1442
Phone
(315) 424-1430
Fax
(315) 424-1779
NPI assigned
Jun 21, 2005
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300287 NY Primary

Addresses

Primary practice location

2949 Erie Blvd E
Suite 110
Syracuse, NY 13224-1442

Mailing address

2949 Erie Blvd East
Suite 110
Syracuse, NY 13224
Phone (315) 424-1430

Other identifiers 1

IdentifierTypeStateIssuer
01712803MedicaidNY

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
I20100212000110 NY Practitioner - Nurse Practitioner 0941344030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ia Tangoren MD PLLCGroup PAC ID 7517858475, 4 clinicians

Practice addresses (Care Compare)

2949 Erie Blvd E
Suite 110
Syracuse, NY 13224-1460
Phone (315) 424-1430

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300287NYMDLicensed Practical Nurse
F300287NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internist Associates of Central New York, PC Current Accepting new patients
I.a. Tangoren, M.D., P.L.L.C. CurrentSince Sep 8, 2014 Accepting new patients
Crouse Medical Practice, PLLC Past Accepting new patients

Locations

2949 Erie Blvd E
Ste 110
Syracuse, NY 13224
Phone (315) 424-1430

739 Irving Ave
Ste 200
Syracuse, NY 13210
Phone (315) 479-5070

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, 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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1104822675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 ERIE BLVD EAST",
            "address_2": "SUITE 110",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13224",
            "telephone_number": "315-424-1430",
            "fax_number": "315-424-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 ERIE BLVD E",
            "address_2": "SUITE 110",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241442",
            "telephone_number": "315-424-1430",
            "fax_number": "315-424-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHU",
        "first_name": "DEBORAH",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "RNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01712803",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.