Individual provider Active NPI

Mary J Hartman, CNM

  • Advanced Practice Midwife
  • Syracuse, NY
National Provider Identifier
1679591804
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F3006061 Issued in NY
Practice address
90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Phone
(315) 464-5210
Fax
(315) 464-2141
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F3006061 NY Primary

Addresses

Primary practice location

90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240

Mailing address

90 Presidential PLZ
3Rd Floor
Syracuse, NY 13202-2240
Phone (315) 464-5210

Other identifiers 1

IdentifierTypeStateIssuer
01716045MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041230000315 NY Practitioner - Certified Nurse Midwife (CNM) 9234197724 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F3006061NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital CurrentSince Jun 23, 2018 Accepting new patients
University OB/GYN Associates CurrentSince Dec 10, 2009 Accepting new patients
Community Memorial Hospital CurrentSince Jun 23, 2018 Accepting new patients

Locations

150 Broad St
Hamilton, NY 13346
Phone (315) 824-1100

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

90 Presidential Plz
Fl 3
Syracuse, NY 13202
Phone (315) 464-4357

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1679591804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-5210",
            "fax_number": "315-464-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-5210",
            "fax_number": "315-464-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F3006061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01716045",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.