Individual provider Active NPI

Jessica Rawson, FNP-BC

  • Family Nurse Practitioner
  • Cicero, NY
National Provider Identifier
1164212874
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F357013-01 Issued in NY
Practice address
8878 Lombardi Dr
Cicero, NY 13039-9703
Phone
(315) 491-7548
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 702726 NY
Family Nurse Practitioner 363LF0000X F357013-01 NY Primary

Addresses

Primary practice location

8878 Lombardi Dr
Cicero, NY 13039-9703

Mailing address

8878 Lombardi Dr
Cicero, NY 13039-9703

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
I20251208003065 NY Practitioner - Nurse Practitioner 0749774750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Genesee St
Suite 403
Syracuse, NY 13210-1840
Phone (315) 464-2929

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
702726NYMDAmbulatory Care Registered Nurse
F357013-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Nov 17, 2025 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Nov 17, 2025 Accepting new patients

Locations

1000 E Genesee St
Ste 400
Syracuse, NY 13210

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

1000 E Genesee St
Ste 403
Syracuse, NY 13210
Phone (315) 464-2929

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1164212874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8878 LOMBARDI DR",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8878 LOMBARDI DR",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399703",
            "telephone_number": "315-491-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWSON",
        "first_name": "JESSICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "702726",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F357013-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

Verify at the official NPI Registry.