Active NPI
Deanna Moore Holtman, N.P.
- Family Nurse Practitioner
- Syracuse, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 333728
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 288542-1 | NY | MD | General Practice Registered Nurse |
| 333728 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suny Health Science Center at Syracuse | Current | Accepting new patients | |
| North Medical PC | Current | Accepting new patients | |
| Suny Health Science Center at Syracuse | Family | Current | Accepting new patients |
| Pathology Associates of Syracuse, PC | Current | Accepting new patients | |
| St Josephs Medical PC | Current | Accepting new patients | |
| Crouse Health Hospital, Inc. | Current | Accepting new patients | |
| Crouse Health Hospital Inc | Current | 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
- 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.
-
- Hospitalist Physician
- Syracuse, NY
- NPI 1841340205
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1033107743
-
- Family Medicine Physician
- Liverpool, NY
- NPI 1972563070
-
- Anatomic Pathology & Clinical Pathology Physician
- Syracuse, NY
- NPI 1629061791
-
- Family Medicine Physician
- Liverpool, NY
- NPI 1942501747
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1184974529
Family
-
- Pharmacy
- Syracuse, NY
- NPI 1306567474
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.