Individual provider Active NPI

Gracia Lynnette Roulan, MSN, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1285989681
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337452 Issued in NY
Practice address
1050 W Genesee St
Syracuse, NY 13204-2243
Phone
(315) 641-2385
Fax
(315) 305-4677
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 337452 NY Primary

Addresses

Primary practice location

1050 W Genesee St
Syracuse, NY 13204-2243

Mailing address

1050 W Genesee St
Syracuse, NY 13204-2243
Phone (315) 477-4663

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
I20120918000820 NY Practitioner - Nurse Practitioner 1557519436 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nascentia Community CareGroup PAC ID 9830098318, 3 clinicians

Practice addresses (Care Compare)

1050 W Genesee St
Syracuse, NY 13204-2243
Phone (315) 641-2385

Hospital & facility affiliations

  • Nascentia Health at Home Home health agency, Syracuse, NY, CCN 337052
  • 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 - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Aug 1, 2018 Accepting new patients
Emergency Care Services of New York, P.C. CurrentSince Jul 3, 2012 Accepting new patients
North Medical PC Current Accepting new patients
Nascentia Community Care CurrentSince Sep 12, 2025 Accepting new patients
St Josephs Hospital Health Center CurrentSince Mar 17, 2014 Accepting new patients
St Josephs Medical PC CurrentSince Aug 27, 2018 Accepting new patients

Locations

830 County Road 64
Elmira, NY 14903
Phone (607) 739-0495

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

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

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

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

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

1050 W Genesee St
Syracuse, NY 13204
Phone (315) 424-3744

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 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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1285989681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042243",
            "telephone_number": "315-477-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042243",
            "telephone_number": "315-641-2385",
            "fax_number": "315-305-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULAN",
        "first_name": "GRACIA",
        "middle_name": "LYNNETTE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.