Individual provider Active NPI

Christopher Michael Souza, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1568023612
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F344484-1 Issued in NY
Practice address
739 Irving Ave Ste 500
Syracuse, NY 13210-1664
Phone
(914) 438-4252
NPI assigned
Jun 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 720528-1 NY
Family Nurse Practitioner 363LF0000X F344484-1 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 500
Syracuse, NY 13210-1664

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (914) 438-4252

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csouza@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

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
I20190909002958 NY Practitioner - Nurse Practitioner 8729317227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

739 Irving Ave
Suite 600
Syracuse, NY 13210-1663
Phone (315) 701-2550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
720528-1NYMDRegistered Nurse
F344484-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Heights Health Center, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Jul 1, 2020 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Jul 1, 2020 Accepting new patients
St Josephs Medical PC PastSince Mar 1, 2020 Accepting new patients

Locations

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

5000 Brittonfield Pkwy
Ste B101
East Syracuse, NY 13057
Phone (315) 470-7409

8324 Oswego Rd
Ste C
Liverpool, NY 13090
Phone (315) 470-7409

736 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 470-7409

739 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 453-4262

739 Irving Ave
Ste 550
Syracuse, NY 13210
Phone (315) 766-1666

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 471-0190

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1568023612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "914-438-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101664",
            "telephone_number": "914-438-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "720528-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344484-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csouza@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 500",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.