Individual provider Active NPI

Jennifer Lynn Coyne, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1366754533
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336378-1 Issued in NY
Practice address
739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Phone
(315) 471-0190
Fax
(315) 471-0170
NPI assigned
Jul 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

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 F336378-1 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 600
Syracuse, NY 13210-1663

Mailing address

739 Irving Ave Ste 600
Syracuse, NY 13210-1663
Phone (315) 471-0190

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
I20110202000396 NY Practitioner - Nurse Practitioner 8022298462 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F336378-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Service Group CurrentSince Jul 31, 2015 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Jul 31, 2015 Accepting new patients
Syracuse Community Health Center CurrentSince Oct 18, 2022 Accepting new patients
Syracuse Community Health Center, Inc. Current Accepting new patients
Island Medical Empire State, PLLC Past Accepting new patients

Locations

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

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

819 S Salina St
Syracuse, NY 13202

725 Irving Ave
Ste 314
Syracuse, NY 13210
Phone (315) 424-0151

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278288000000",
    "number": "1366754533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101663",
            "telephone_number": "315-471-0190",
            "fax_number": "315-471-0170"
        },
        {
            "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": "315-471-0190",
            "fax_number": "315-471-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2010-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336378-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.