Individual provider Active NPI

Leonard Dewayne Hurteau

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1508558990
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334672-01 Issued in NY
Practice address
4797 Countryside Dr
Syracuse, NY 13215-9703
Phone
(315) 345-0564
NPI assigned
May 23, 2023
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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 F334672-01 NY Primary

Addresses

Primary practice location

4797 Countryside Dr
Syracuse, NY 13215-9703

Mailing address

4797 Countryside Dr
Syracuse, NY 13215-9703
Phone (315) 345-0564

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

State licenses

LicenseStateTypeSpecialty
F334672-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Farnham Inc. Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1508558990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4797 COUNTRYSIDE DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159703",
            "telephone_number": "315-345-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4797 COUNTRYSIDE DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159703",
            "telephone_number": "315-345-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTEAU",
        "first_name": "LEONARD",
        "middle_name": "DEWAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334672-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.