Individual provider Active NPI

Jacqueline Cristine Depaulis Fiumano, N.P.

  • Family Nurse Practitioner
  • Baldwinsville, NY
National Provider Identifier
1245322999
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338567 Issued in NY
Practice address
3070 Belgium Rd
Baldwinsville, NY 13027-9239
Phone
(315) 671-5790
Fax
(315) 671-5791
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 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 F338567 NY Primary

Addresses

Primary practice location

3070 Belgium Rd
Baldwinsville, NY 13027-9239

Mailing address

3466 Van Wie Dr E
Baldwinsville, NY 13027-8910
Phone (315) 415-2050

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
I20070129000254 NY Practitioner - Nurse Practitioner 6507867918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F338567NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Apr 28, 2024 Accepting new patients
Northway Medical Associates, PLLC CurrentSince Aug 12, 2011 Accepting new patients
Guardian Biologics LLC CurrentSince Jan 1, 2024 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital Inc CurrentSince Apr 28, 2024 Accepting new patients
Family Care Medical Group PC PastSince Jan 1, 2016 Accepting new patients

Locations

7439 Canton Street Rd
Baldwinsville, NY 13027
Phone (865) 323-2500

3070 Belgium Rd
Baldwinsville, NY 13027
Phone (315) 635-5700

21 N 2nd St
Fulton, NY 13069
Phone (315) 564-7085

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 6

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1245322999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3466 VAN WIE DR E",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130278910",
            "telephone_number": "315-415-2050",
            "fax_number": "315-671-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 BELGIUM RD",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130279239",
            "telephone_number": "315-671-5790",
            "fax_number": "315-671-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAULIS FIUMANO",
        "first_name": "JACQUELINE",
        "middle_name": "CRISTINE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinsville, NY

Sources for this page

Verify at the official NPI Registry.