Individual provider Active NPI

Mary A Pensero, RN

  • Local Education Agency (LEA)
  • Oswego, NY
National Provider Identifier
1477000610
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
477587-1 Issued in NY
Practice address
12 Meaney Circle Ext
Oswego, NY 13126-6180
Phone
(315) 342-3410
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X 477587-1 NY Primary

Addresses

Primary practice location

12 Meaney Circle Ext
Oswego, NY 13126-6180

Mailing address

12 Meaney Circle Ext
12 M
Oswego, NY 13126-6180
Phone (315) 342-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
477587-1NYMDLocal Education Agency (LEA)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1477000610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MEANEY CIRCLE EXT",
            "address_2": "12 M",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266180",
            "telephone_number": "315-342-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MEANEY CIRCLE EXT",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266180",
            "telephone_number": "315-342-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENSERO",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NY",
            "license": "477587-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.