Individual provider Active NPI

Amy L Wilson, NP

  • Registered Nurse First Assistant
  • Syracuse, NY
National Provider Identifier
1447404496
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
335606 Issued in NY
Practice address
750 East Adams Street
Syracuse, NY 13210
Phone
(315) 448-2713
Fax
(315) 744-1321
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 335606 NY Primary
Family Nurse Practitioner 363LF0000X 335606 NY
Nurse Practitioner 363L00000X 335606 NY

Addresses

Primary practice location

750 East Adams Street
Syracuse, NY 13210

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

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
I20090126000562 NY Practitioner - Nurse Practitioner 8820152481 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Mar 31, 2022 Accepting new patients
Suny Health Science Center at Syracuse Nurse Practitioner CurrentSince Mar 31, 2022 Accepting new patients
St Josephs Medical PC CurrentSince Sep 11, 2018 Accepting new patients
North Medical PC Current Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

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

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

1000 E Genesee St
Ste 300
Syracuse, NY 13210
Phone (315) 471-1044

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

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: awilson137318@direct.upstate.edu

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1447404496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111",
            "fax_number": "315-703-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-448-2713",
            "fax_number": "315-744-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "NY",
            "license": "335606",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335606",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "335606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.