Individual provider Active NPI

Elissa D Townsend, FNP-C

  • Family Nurse Practitioner
  • Watertown, NY
National Provider Identifier
1629328422
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18018 Issued in SC
Practice address
20053 Summit View Blvd Ste 1B
Watertown, NY 13601-2169
Phone
(315) 755-2560
Fax
(315) 755-2597
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18018 SC Primary

Addresses

Primary practice location

20053 Summit View Blvd Ste 1B
Watertown, NY 13601-2169

Mailing address

19472 Nys Route 11
Suite N101
Watertown, NY 13601-0265
Phone (315) 786-1924

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
I20210406001749 NY Practitioner - Nurse Practitioner 2466605324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Northern Nurse Practitioners-Family Health PLLCGroup PAC ID 2668451998, 5 clinicians
Jill M Laureano Surber DO PCGroup PAC ID 9335463405, 5 clinicians

Practice addresses (Care Compare)

19472 US Route 11
Watertown, NY 13601-6897
Phone (315) 786-1924

20053 Summit View Blvd
Suite 1
Watertown, NY 13601-2170
Phone (315) 755-2560

Hospital & facility affiliations

  • Fayette County Hospital Hospital, Vandalia, IL, CCN 141346
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

Merit-based Incentive Payment System (MIPS)

Final score
87.13 of 100Reported as group
Quality
74.26
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jill M Laureano Surber DO PC CurrentSince Jul 28, 2026 Accepting new patients
Northern Nurse Practitioners - Family Health PLLC Family CurrentSince Dec 15, 2020 Accepting new patients
Eye Plastic and Reconstructive Surgery of Cny PC PastSince Jul 28, 2026 Accepting new patients

Locations

19472 US Route 11
Watertown, NY 13601
Phone (315) 782-6126

19472 US Route 11
Ste N101
Watertown, NY 13601
Phone (315) 422-3937

20053 Summit View Blvd
Ste 1
Watertown, NY 13601
Phone (315) 755-2560

Organizations & group practices 3

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 2

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1629328422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19472 NYS ROUTE 11",
            "address_2": "SUITE N101",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136010265",
            "telephone_number": "315-786-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20053 SUMMIT VIEW BLVD STE 1B",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012169",
            "telephone_number": "315-755-2560",
            "fax_number": "315-755-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "ELISSA",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.