Individual provider Active NPI

Maysae Sancrown, FNP

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1407110919
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337408 Issued in NY
Practice address
1256 Culver Ave
Utica, NY 13501-4253
Phone
(315) 738-7186
Fax
(315) 738-0188
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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 F337408 NY Primary

Addresses

Primary practice location

1256 Culver Ave
Utica, NY 13501-4253

Mailing address

2209 Genesee Street
Business Offfice Room 315
Utica, NY 13501-5631
Phone (315) 801-3282

Other identifiers 1

IdentifierTypeStateIssuer
03504189MedicaidNY

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
I20121017000042 NY Practitioner - Nurse Practitioner 5597915199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F337408NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Jul 23, 2012 Accepting new patients
MVHS Inc CurrentSince Jul 23, 2012 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

1256 Culver Ave
Utica, NY 13501
Phone (315) 738-7186

1904 Genesee St
Utica, NY 13502
Phone (315) 793-8856

120 Hobart St
Utica, NY 13501
Phone (315) 798-1149

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

6 Hampden Pl
Utica, NY 13502
Phone (315) 624-3666

Interoperability endpoints

  • Direct secure messaging: msancrown13599@mvhealthsystem.direct-ci.com
  • Direct secure messaging: msancrown@hiemail.healtheconnections.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1407110919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE STREET",
            "address_2": "BUSINESS OFFFICE ROOM 315",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015631",
            "telephone_number": "315-801-3282",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 CULVER AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014253",
            "telephone_number": "315-738-7186",
            "fax_number": "315-738-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCROWN",
        "first_name": "MAYSAE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03504189",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.