Individual provider Active NPI

Sara E Hebert, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1407386048
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341840 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7411
NPI assigned
Jun 15, 2017
Last updated
Oct 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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 341840 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

251 Salina Meadows Pkwy Ste 100
Syracuse, NY 13212-4516
Phone (315) 464-2000

Other identifiers 1

IdentifierTypeStateIssuer
04836297MedicaidNY

Other names 1

  • Ms. Sara E Wyker Former name

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
I20170811001584 NY Practitioner - Nurse Practitioner 8921379736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
341840NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Jun 15, 2017 Accepting new patients
University OB/GYN Associates CurrentSince Apr 10, 2019 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital Inc CurrentSince Jun 15, 2017 Accepting new patients

Locations

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

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

Organizations & group practices 4

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 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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1407386048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PKWY STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124516",
            "telephone_number": "315-464-2000",
            "fax_number": "315-464-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "SARA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04836297",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "WYKER",
            "middle_name": "E",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.