Individual provider Active NPI

Kyra Danneker, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1528553336
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402407 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-1834
Phone
(315) 464-2500
NPI assigned
Jun 25, 2018
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402407 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-1834

Mailing address

225 Wilkinson St Apt 302
Syracuse, NY 13204-2478
Phone (814) 933-9887

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
I20180830001581 NY Practitioner - Nurse Practitioner 2961752613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.28 of 100Reported as group
Quality
88.2
Promoting interoperability
100
Improvement activities
40
Cost
69.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Faculty Practice, Inc. CurrentSince Jul 7, 2018 Accepting new patients

Locations

713 Harrison St
Syracuse, NY 13210
Phone (315) 464-3145

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

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

Interoperability endpoints

  • Direct secure messaging: kdanneker30751@direct.upstate.edu

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1528553336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WILKINSON ST APT 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042478",
            "telephone_number": "814-933-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101834",
            "telephone_number": "315-464-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNEKER",
        "first_name": "KYRA",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.