Individual provider Active NPI

Jeanne E Pietrzak, M.S.N, R.N., N.P

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1679547392
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
303995 Issued in NY
Practice address
739 Irving Ave Ste 500
Syracuse, NY 13210-1664
Phone
(315) 470-7409
Fax
(315) 475-2357
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 303995 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 500
Syracuse, NY 13210-1664

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 470-7409

Other identifiers 1

IdentifierTypeStateIssuer
03303028MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpietrzak@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

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
I20070215000448 NY Practitioner - Nurse Practitioner 5597767855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

739 Irving Ave
Suite 500
Syracuse, NY 13210-1664
Phone (315) 470-7409

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
303995NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice, PLLC Nurse Practitioner CurrentSince Nov 8, 2016 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Nov 8, 2016 Accepting new patients

Locations

5000 Brittonfield Pkwy
Ste B101
East Syracuse, NY 13057
Phone (315) 470-7409

4820 W Taft Rd
Ste 209
Liverpool, NY 13088
Phone (315) 448-6125

4820 W Taft Rd
Ste 201
Liverpool, NY 13088
Phone (315) 234-0906

4500 Pewter Ln
Bldg 1
Manlius, NY 13104
Phone (315) 470-7409

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 453-4262

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

739 Irving Ave
Ste 550
Syracuse, NY 13210
Phone (315) 766-1666

Interoperability endpoints

  • Direct secure messaging: jpietrzak@crousemed.medentdirect.com

Organizations & group practices 2

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 5

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1679547392",
    "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": "315-470-7409",
            "fax_number": "315-475-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 500",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101664",
            "telephone_number": "315-470-7409",
            "fax_number": "315-475-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRZAK",
        "first_name": "JEANNE",
        "middle_name": "E",
        "credential": "M.S.N, R.N., N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "303995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03303028",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpietrzak@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 500",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.