Individual provider Active NPI

Kimberly P. Sutryk, FNP

  • Nurse Practitioner
  • Corning, NY
National Provider Identifier
1154396380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F334362 Issued in NY
Practice address
123 Conhocton St
Corning, NY 14830-2911
Phone
(607) 973-8600
Fax
(607) 962-5102
NPI assigned
Feb 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 F334362 NY Primary

Addresses

Primary practice location

123 Conhocton St
Corning, NY 14830-2911

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 1

IdentifierTypeStateIssuer
02644571MedicaidNY

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
I20050525000396 NY Practitioner - Nurse Practitioner 0446292957 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schuyler Hospital IncGroup PAC ID 3577548262, shared by 6 NPIs, 41 clinicians

Practice addresses (Care Compare)

220 Steuben St
Montour Falls, NY 14865-9740
Phone 607535863952353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F334362NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. CurrentSince Dec 18, 2010 Accepting new patients
Schuyler Hospital Inc CurrentSince Jan 14, 2026 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Sep 15, 2019 Accepting new patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Cma Medical Practice PLLC CurrentSince Dec 31, 2019 Accepting new patients
Atlantic Physician Services of Maryland, PC Past Accepting new patients
Atlantic Physician Services of Maryland, P.C. Nurse Practitioner Past Accepting new patients

Locations

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

1129 Commons Ave
#C
Cortland, NY 13045
Phone (607) 339-0456

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Interoperability endpoints

  • Direct secure messaging: ksutryk8004@direct-guthrie.org

Organizations & group practices 8

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 2

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154396380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858",
            "fax_number": "570-882-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CONHOCTON ST",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302911",
            "telephone_number": "607-973-8600",
            "fax_number": "607-962-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTRYK",
        "first_name": "KIMBERLY",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F334362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02644571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, NY

Sources for this page

Verify at the official NPI Registry.