Individual provider Active NPI

Colleen Marie Wellington, FNP

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1376434696
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
356906 Issued in NY
Practice address
725 E Adams St
Syracuse, NY 13210-2576
Phone
(315) 464-4686
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 356906 NY Primary

Addresses

Primary practice location

725 E Adams St
Syracuse, NY 13210-2576

Mailing address

13774 Jenkins Rd
Red Creek, NY 13143-3142
Phone (315) 956-5115

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
I20251003002249 NY Practitioner - Nurse Practitioner 4082110457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Family and Preventive Medicine IncGroup PAC ID 6800185711, 30 clinicians

Practice addresses (Care Compare)

725 E Adams St
Syracuse, NY 13210-2576
Phone (315) 464-4686

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
356906NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Family and Preventive Medicine, Inc Family Medicine CurrentSince Sep 2, 2025 Accepting new patients
Family Medicine Medical Service Group Family Medicine PastSince Jul 23, 2015 Accepting new patients

Locations

725 E Adams St
Syracuse, NY 13210
Phone (315) 464-4357

6712 Brooklawn Pkwy
Ste 204
Syracuse, NY 13211
Phone (315) 432-8899

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

Interoperability endpoints

  • Direct secure messaging: cwellington12011@direct.upstate.edu

Organizations & group practices 2

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 1

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1376434696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13774 JENKINS RD",
            "city": "RED CREEK",
            "state": "NY",
            "postal_code": "131433142",
            "telephone_number": "315-956-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102576",
            "telephone_number": "315-464-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "356906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.