Individual provider Active NPI

Luann Mary Thayer, NP

  • Nurse Practitioner
  • Oneida, NY
National Provider Identifier
1629053764
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F332301-1 Issued in NY
Practice address
357 Genesee St Ste 1
Oneida, NY 13421-2658
Phone
(315) 363-8862
Fax
(315) 363-3326
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F332301-1 NY Primary

Addresses

Primary practice location

357 Genesee St Ste 1
Oneida, NY 13421-2658

Mailing address

357 Genesee St Ste 1
Oneida, NY 13421-2658
Phone (315) 363-8862

Other identifiers 1

IdentifierTypeStateIssuer
02509048MedicaidNY

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
I20040303000779 NY Practitioner - Nurse Practitioner 3971490939 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F332301-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Neurosurgery LLP CurrentSince Jul 26, 2004 Accepting new patients
Neurosurgical Associates of Central New York, LLP CurrentSince Jul 26, 2004 Accepting new patients
Rome Memorial Hospital, Inc. Current Accepting new patients
Scott Gingold MD Past Accepting new patients

Locations

107 E Chestnut St
Ste 102
Rome, NY 13440
Phone (315) 338-9200

4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470

Interoperability endpoints

  • Direct secure messaging: lthayer@rmh.medalliesdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1629053764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 GENESEE ST STE 1",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212658",
            "telephone_number": "315-363-8862",
            "fax_number": "315-363-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 GENESEE ST STE 1",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212658",
            "telephone_number": "315-363-8862",
            "fax_number": "315-363-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "LUANN",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332301-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02509048",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, NY

Sources for this page

Verify at the official NPI Registry.