Individual provider Active NPI

Roselynn Knapp Kingsbury, APRN, BC

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1518152917
Registry record updated Sep 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333541-1 Issued in NY
Practice address
555 S State St
Syracuse, NY 13202-2104
Phone
(315) 435-1790
Fax
(315) 435-1729
NPI assigned
Sep 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2007

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 F333541-1 NY Primary

Addresses

Primary practice location

555 S State St
Syracuse, NY 13202-2104

Mailing address

555 S State St
Syracuse, NY 13202-2104
Phone (315) 435-1790

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
I20171122001037 NY Practitioner - Nurse Practitioner 0244597508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F333541-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loretto Health and Rehabilitation Center CurrentSince Oct 14, 2017 Accepting new patients

Locations

700 E Brighton Ave
Syracuse, NY 13205
Phone (315) 469-5570

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189296000000",
    "number": "1518152917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S STATE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022104",
            "telephone_number": "315-435-1790",
            "fax_number": "315-435-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S STATE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022104",
            "telephone_number": "315-435-1790",
            "fax_number": "315-435-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBURY",
        "first_name": "ROSELYNN",
        "middle_name": "KNAPP",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-09",
        "last_updated": "2007-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333541-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.