Individual provider Active NPI

Sherri McMullen, NP

  • Neonatal Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1679616486
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
F350102 Issued in NY
Practice address
301 Prospect Ave
Nicu
Syracuse, NY 13203-1807
Phone
(315) 448-5111
Fax
(315) 703-5079
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X F350102 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Nicu
Syracuse, NY 13203-1807

Mailing address

104 Union Ave
Suite 804
Syracuse, NY 13203-1843
Phone (315) 703-5049

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
I20190402001490 NY Practitioner - Nurse Practitioner 2769723659 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F350102NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Nov 7, 2023 Accepting new patients
St Josephs Medical PC CurrentSince Mar 10, 2020 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Feb 23, 2019 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Feb 23, 2019 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Nov 7, 2023 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients
University Surgical Associates, LLP Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

315 S Manning Blvd
Rm 6512
Albany, NY 12208
Phone (518) 525-1304

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

4900 Broad Rd
Ste 2G
Syracuse, NY 13215
Phone (315) 299-5313

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

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

104 Union Ave
Ste 804
Syracuse, NY 13203
Phone (315) 703-5049

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Interoperability endpoints

  • Direct secure messaging: smcmullen54232@direct.upstate.edu
  • Direct secure messaging: smcmullen2388869@direct.trinity-health.org

Organizations & group practices 8

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1679616486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 UNION AVE",
            "address_2": "SUITE 804",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031843",
            "telephone_number": "315-703-5049",
            "fax_number": "315-703-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "NICU",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111",
            "fax_number": "315-703-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "SHERRI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "F350102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.