Individual provider Active NPI

Tracee A Young, FNP-C

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1609602309
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354577 Issued in NY
Practice address
725 E Adams St
4TH Floor
Syracuse, NY 13210
Phone
(315) 464-4686
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2958962 NY
Family Nurse Practitioner 363LF0000X 354577 NY Primary

Addresses

Primary practice location

725 E Adams St
4TH Floor
Syracuse, NY 13210

Mailing address

725 E Adams St
4TH Floor
Syracuse, NY 13210
Phone (315) 464-4686

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
I20241108003106 NY Practitioner - Nurse Practitioner 4688108996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Family and Preventive Medicine IncGroup PAC ID 6800185711, 30 clinicians

Practice addresses (Care Compare)

725 E Adams St
Syracuse, NY 13210-2576
Phone (315) 464-4686

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2958962NYMDFamily Nurse Practitioner
354577NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Family and Preventive Medicine, Inc CurrentSince Oct 1, 2024 Accepting new patients
Family Medicine Medical Service Group PastSince Jul 23, 2015 Accepting new patients

Locations

725 E Adams St
Syracuse, NY 13210
Phone (315) 464-4357

6712 Brooklawn Pkwy
Ste 204
Syracuse, NY 13211
Phone (315) 432-8899

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

Interoperability endpoints

  • Direct secure messaging: tyoung146433@direct.upstate.edu

Organizations & group practices 2

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 1

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1609602309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E ADAMS ST",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TRACEE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-10-24",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "2958962",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.