Individual provider Active NPI

Cortney Fedyshyn, FNP-C

  • Family Nurse Practitioner
  • Auburn, NY
National Provider Identifier
1295165041
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339601 Issued in NY
Practice address
271 Grant Ave
Auburn, NY 13021-1407
Phone
(315) 704-6097
NPI assigned
Nov 14, 2013
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F1013558 FL
Family Nurse Practitioner 363LF0000X 339601 NY Primary

Addresses

Primary practice location

271 Grant Ave
Auburn, NY 13021-1407

Mailing address

14 Bristol Lane
Ellicottville, NY 14731
Phone (941) 952-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F1013558FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Primary Care Practice, PC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1295165041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BRISTOL LANE",
            "city": "ELLICOTTVILLE",
            "state": "NY",
            "postal_code": "14731",
            "telephone_number": "941-952-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GRANT AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211407",
            "telephone_number": "315-704-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDYSHYN",
        "first_name": "CORTNEY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F1013558",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.