Gina Alexandra Pucello, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F341819 Issued in NY

Practice address

1045 James St Ste 100
Syracuse, NY 13203-2758

Phone

(315) 472-4471

Fax

(315) 679-5990

NPI assigned

Jul 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

State University of Ny Upstate Medical University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gina.pucello.p1@direct.liberty-resources.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Liberty Resources Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Syracuse, NY
  • NPI 1225254881
  Medicare reassignment Care Compare group NPD
• Liberty Resources Inc.

  • Foster Care Agency
  • Syracuse, NY
  • NPI 1447821376
  NPD
• Liberty Resources, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, NY
  • NPI 1700688827
  NPD
• Allara Medical Group PA

  • Gynecology Physician
  • New York, NY
  • NPI 1700450558
  NPD (past)
• Cathy J. Berry, M.D., P.C.

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
  • NPI 1992784573
  NPD (past)
• Liberty Resources, Inc.

  • Primary Care Clinic/Center
  • Syracuse, NY
  • NPI 1821485483
  NPD (past)

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1669996070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471",
            "fax_number": "315-679-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032758",
            "telephone_number": "315-472-4471",
            "fax_number": "315-679-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCELLO",
        "first_name": "GINA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psychiatry Services of New York, P.C.
• Psychological & Family Services
• Psychological Healthcare, PLLC
• Sheila M Ptak, NP
• Mihael J Puc, MD
• Jacey M Pudney, MD
• Jennifer Pugh, PH.D
• Anna Puk
• Frena Pulami Magar, MBBS
• Michelle Lynn Pullano-Sellin, FNP-C

• Family Nurse Practitioner in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.