Individual provider Active NPI

Olena Andriyivna Stout, FNP

  • Family Nurse Practitioner
  • Rome, NY
National Provider Identifier
1306684725
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354443 Issued in NY
Practice address
1500 N James St
Rome, NY 13440-2844
Phone
(315) 338-7184
Fax
(315) 339-1975
NPI assigned
Jul 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 354443 NY Primary

Addresses

Primary practice location

1500 N James St
Rome, NY 13440-2844

Mailing address

245 Avery LN
Rome, NY 13441-4237
Phone (315) 337-1200

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
I20240911002342 NY Practitioner - Nurse Practitioner 1658811161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Syracuse, P.C.Group PAC ID 2769379015, 13 clinicians
Rome Memorial Hospital, Inc.Group PAC ID 9638087273, 56 clinicians

Practice addresses (Care Compare)

1304 Buckley Rd
Suite 200
Syracuse, NY 13212-4317
Phone (315) 478-3311

1500 N James St
Rome, NY 13440-2844
Phone (315) 338-7021

Hospital & facility affiliations

  • Rome Memorial Hospital, Inc Hospital, Rome, NY, CCN 330215

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
354443NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rome Memorial Hospital, Inc. CurrentSince Dec 22, 2025 Accepting new patients
Rome Memorial Hospital, Inc. CurrentSince Dec 22, 2025 Accepting new patients
Nephrology Associates of Syracuse, P.C. CurrentSince Oct 1, 2024 Accepting new patients
St Josephs Medical PC Past Accepting new patients
Lyncourt Footcare PC Past Accepting new patients

Locations

5700 W Genesee St
Ste 211
Camillus, NY 13031
Phone (315) 410-6400

4000 Medical Center Dr
#101D
Fayetteville, NY 13066

522 S 4th St
Ste 400
Fulton, NY 13069
Phone (315) 452-4670

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

1304 Buckley Rd
Ste 200
Syracuse, NY 13212
Phone (315) 478-3311

4857 State Route 5
Vernon, NY 13476
Phone (315) 363-9995

Organizations & group practices 5

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 8

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": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1306684725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 AVERY LN",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414237",
            "telephone_number": "315-337-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N JAMES ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402844",
            "telephone_number": "315-338-7184",
            "fax_number": "315-339-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "OLENA",
        "middle_name": "ANDRIYIVNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

Verify at the official NPI Registry.