Individual provider Active NPI

Deanna Moore Holtman, N.P.

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1619075959
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333728 Issued in NY
Practice address
739 Irving Ave Ste 450
Syracuse, NY 13210-1663
Phone
(315) 470-7364
Fax
(315) 378-0828
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 288542-1 NY
Family Nurse Practitioner 363LF0000X 333728 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 450
Syracuse, NY 13210-1663

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288542-1NYMDGeneral Practice Registered Nurse
333728NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse CurrentSince Jul 27, 2014 Accepting new patients
North Medical PC Current Accepting new patients
Suny Health Science Center at Syracuse Family CurrentSince Jul 27, 2014 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
St Josephs Medical PC CurrentSince Feb 20, 2023 Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Crouse Health Hospital Inc CurrentSince Nov 1, 2016 Accepting new patients

Locations

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

739 Irving Ave
Ste 450
Syracuse, NY 13210
Phone (315) 470-7364

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: dholtman2554290@direct.trinity-health.org

Organizations & group practices 7

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1619075959",
    "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": "315-937-3433",
            "fax_number": "315-464-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 450",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101663",
            "telephone_number": "315-470-7364",
            "fax_number": "315-378-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTMAN",
        "first_name": "DEANNA",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "288542-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.