Individual provider Active NPI

Ashley Lynn McIntosh, NP

  • Adult Health Nurse Practitioner
  • Fayetteville, NY
National Provider Identifier
1609417856
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309426 Issued in NY
Practice address
4000 Medical Center Drive Suite 115
Fayetteville, NY 13066
Phone
(315) 329-2555
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309426 NY Primary

Addresses

Primary practice location

4000 Medical Center Drive Suite 115
Fayetteville, NY 13066

Mailing address

4587 Limeledge Rd
Marcellus, NY 13108-9774
Phone (315) 751-3567

Other practice location 1

1000 South Ave
Rochester, NY 14620-2733
Phone (585) 341-0166

Other practice location 2

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

Other names 1

  • Ashley Lynn Martin Other name

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
I20210820001626 NY Practitioner - Nurse Practitioner 3971930991 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
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

4101 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

4103 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1500

4117 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1551

5100 W Taft Rd
Liverpool, NY 13088-4841

5301 W Genesee St
Camillus, NY 13031-2238

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309426NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC CurrentSince Dec 1, 2025 Accepting new patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Oct 18, 2021 Accepting new patients
North Medical PC Current Accepting new patients
Syracuse Orthopedic Specialists, PLLC PastSince Oct 18, 2021 Accepting new patients

Locations

4000 Medical Center Dr
Ste 115
Fayetteville, NY 13066
Phone (315) 329-2555

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

5496 E Taft Rd
Ste C
North Syracuse, NY 13212
Phone (315) 251-3232

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

Organizations & group practices 4

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1609417856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4587 LIMELEDGE RD",
            "city": "MARCELLUS",
            "state": "NY",
            "postal_code": "131089774",
            "telephone_number": "315-751-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE SUITE 115",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-329-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 South Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202733",
            "country_code": "US",
            "telephone_number": "585-341-0166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132031807",
            "country_code": "US",
            "telephone_number": "315-448-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MARTIN",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.