Individual provider Active NPI

Joann Pamela Gillette, NP

  • Primary Care Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1649800202
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
309518 Issued in NY
Practice address
918 James St
Syracuse, NY 13203-2500
Phone
(844) 362-3425
Fax
(718) 362-8185
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 309518 NY Primary

Addresses

Primary practice location

918 James St
Syracuse, NY 13203-2500

Mailing address

612 Corporate Way Ste 1M
Valley Cottage, NY 10989-2027
Phone (844) 362-3425

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL CMA

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
I20200326000690 NY Practitioner - Nurse Practitioner 6406285402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4457

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
87.56 of 100Reported as group
Quality
71.97
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309518NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Mar 1, 2022 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Mar 1, 2022 Accepting new patients
Dial Doc Now Medical Group PC CurrentSince Dec 1, 2021 Accepting new patients

Locations

10 James St
Homer, NY 13077
Phone (607) 749-2640

1000 E Genesee St
Ste 403
Syracuse, NY 13210
Phone (315) 464-2929

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

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

Interoperability endpoints

  • Direct secure messaging: jgillette130721@direct.upstate.edu

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 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": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1649800202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 1M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "844-362-3425",
            "fax_number": "718-362-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032500",
            "telephone_number": "844-362-3425",
            "fax_number": "718-362-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JOANN",
        "middle_name": "PAMELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "309518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CMA",
            "affiliation": "N",
            "address_1": "905 Hanshaw Rd Ste C",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.