Individual provider Active NPI

Adam Ullman

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1114308947
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352300 Issued in NY
Practice address
2614 Genesee St
Utica, NY 13502-6003
Phone
(315) 793-0090
NPI assigned
Jun 17, 2015
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 647364 NY
Family Nurse Practitioner 363LF0000X 352300 NY Primary

Addresses

Primary practice location

2614 Genesee St
Utica, NY 13502-6003

Mailing address

2614 Genesee St
Utica, NY 13502-6003

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
I20240404001415 NY Practitioner - Nurse Practitioner 5698113090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cny Spine and Pain Medicine LLCGroup PAC ID 5597908202, 11 clinicians

Practice addresses (Care Compare)

7449 Morgan Rd
Liverpool, NY 13090-3973
Phone (315) 451-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
647364NYMDRegistered Nurse
352300NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Spine and Pain Medicine LLC CurrentSince Feb 25, 2024 Accepting new patients
Cny Spine and Pain Medicine LLC CurrentSince Feb 25, 2024 Accepting new patients

Locations

7449 Morgan Rd
Liverpool, NY 13090
Phone (315) 451-5400

6 Business Park Ct
Utica, NY 13502
Phone (315) 624-9082

Interoperability endpoints

  • Direct secure messaging: aullman@cny.curemd.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1114308947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003",
            "telephone_number": "315-793-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLMAN",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "647364",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.