NPIMap

Individual provider Active NPI

Shelby Nichole Gambill, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1356984611
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345187 Issued in NY
Practice address
739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Phone
(315) 701-2550
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345187 NY Primary
Family Nurse Practitioner 363LF0000X RN260470 GA
Family Nurse Practitioner 363LF0000X APRN11006019 FL

Addresses

Primary practice location

739 Irving Ave Ste 600
Syracuse, NY 13210-1663

Mailing address

1001 W Fayette St Ste 4003
Syracuse, NY 13204-2859
Phone (315) 937-3433

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgambill@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210106003069 FL Practitioner - Nurse Practitioner 6608289863
I20221128000962 NY Practitioner - Nurse Practitioner 6608289863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

555 French Rd
Suite 102
New Hartford, NY 13413-1070
Phone (315) 701-2550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN260470GAMDFamily Nurse Practitioner
345187NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central New York Brain & Spine Neurosurgery PLLC CurrentSince Nov 1, 2022 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Jul 1, 2023 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Jul 1, 2023 Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients
Georgia Spine & Pain Centers Past Accepting new patients

Locations

83 Genesee St
New Hartford, NY 13413
Phone (315) 732-0995

555 French Rd
Bldg 2
New Hartford, NY 13413
Phone (315) 701-2550

107 E Chestnut St
Ste 105
Rome, NY 13440
Phone (315) 336-8302

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

739 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 471-0190

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

Interoperability endpoints

  • Direct secure messaging: sgambill@crousemed.medentdirect.com

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 11

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1356984611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 4003",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101663",
            "telephone_number": "315-701-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "SHELBY",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345187",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260470",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgambill@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sgambill@crousemed.medentdirect.com",
            "address_1": "739 Irving Ave Ste 600",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.