Individual provider Active NPI

Elaine Mary Scherba-Germain

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1154420230
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
400816 Issued in NY
Practice address
4898 Royal Crab Ave
Syracuse, NY 13215-9310
Phone
(315) 430-7586
Fax
(315) 498-9129
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 321851 NY
Adult Health Nurse Practitioner 363LA2200X 301483 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 400816 NY Primary

Addresses

Primary practice location

4898 Royal Crab Ave
Syracuse, NY 13215-9310

Mailing address

4898 Royal Crab Ave
Syracuse, NY 13215-9310
Phone (315) 430-7586

Other identifiers 3

IdentifierTypeStateIssuer
02994838OtherNYOCMS GRP MCD
1235184235OtherOCMS GRP NPI
BA1047OtherOCMS GRP MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
321851NYMDPsychiatric/Mental Health Registered Nurse
301483NYMDAdult Health Nurse Practitioner
400816NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Group Health Association Past Accepting new patients

Organizations & group practices 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1154420230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4898 ROYAL CRAB AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159310",
            "telephone_number": "315-430-7586",
            "fax_number": "315-498-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4898 ROYAL CRAB AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159310",
            "telephone_number": "315-430-7586",
            "fax_number": "315-498-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERBA-GERMAIN",
        "first_name": "ELAINE",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "321851",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301483",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "400816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCMS GRP MCD",
            "identifier": "02994838",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCMS GRP NPI",
            "identifier": "1235184235",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCMS GRP MCR",
            "identifier": "BA1047",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.