Individual provider Active NPI

Elizabeth Marie Carrigan

  • Family Nurse Practitioner
  • Liverpool, NY
National Provider Identifier
1114399599
Registry record updated Jan 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339778-1 Issued in NY
Practice address
4820 W Taft Rd
Suite 201
Liverpool, NY 13088-2800
Phone
(315) 448-6215
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F339778-1 NY Primary

Addresses

Primary practice location

4820 W Taft Rd
Suite 201
Liverpool, NY 13088-2800

Mailing address

4820 W Taft Rd
Liverpool, NY 13088-2800
Phone (315) 448-6215

Other names 1

  • Miss Elizabeth Marie Mancuso Former name

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
I20160112002739 NY Practitioner - Nurse Practitioner 4981906658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339778NYMDLicensed Practical Nurse
F339778-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients
St Josephs Medical PC CurrentSince Jun 1, 2017 Accepting new patients

Locations

4820 W Taft Rd
Ste 209
Liverpool, NY 13088
Phone (315) 448-6125

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

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: ecarrigan2387298@direct.trinity-health.org

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 and National Provider Directory roles.

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453593600000",
    "number": "1114399599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882800",
            "telephone_number": "315-448-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD",
            "address_2": "SUITE 201",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882800",
            "telephone_number": "315-448-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIGAN",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2016-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339778-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MANCUSO",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.