Individual provider Active NPI

Nicholas Scot Gilfus, FNP

  • Family Nurse Practitioner
  • Elbridge, NY
National Provider Identifier
1417311523
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339935 Issued in NY
Practice address
247 E Main St
Elbridge, NY 13060-8706
Phone
(315) 689-0001
Fax
(315) 277-5311
NPI assigned
Apr 6, 2016
Last updated
Sep 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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 339935 NY Primary

Addresses

Primary practice location

247 E Main St
Elbridge, NY 13060-8706

Mailing address

247 E Main St
Elbridge, NY 13060
Phone (315) 689-0001

Other identifiers 1

IdentifierTypeStateIssuer
04458706MedicaidNY

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
I20170224000568 NY Practitioner - Nurse Practitioner 4082998794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preventive Medicine Associates LLCGroup PAC ID 5294740924, 7 clinicians

Practice addresses (Care Compare)

5415 W Genesee St
Suite 301
Camillus, NY 13031-2162
Phone (315) 487-8109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
94.69
Improvement activities
40
Cost
76.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preventive Medicine Associates LLC CurrentSince May 23, 2022 Accepting new patients

Locations

5415 W Genesee St
Ste 301
Camillus, NY 13031
Phone (315) 487-8109

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 4

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1417311523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 E MAIN ST",
            "city": "ELBRIDGE",
            "state": "NY",
            "postal_code": "13060",
            "telephone_number": "315-689-0001",
            "fax_number": "315-277-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 E MAIN ST",
            "city": "ELBRIDGE",
            "state": "NY",
            "postal_code": "130608706",
            "telephone_number": "315-689-0001",
            "fax_number": "315-277-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILFUS",
        "first_name": "NICHOLAS",
        "middle_name": "SCOT",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04458706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elbridge, NY

Sources for this page

Verify at the official NPI Registry.