Individual provider Active NPI

Susan Marie Converse, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1679702336
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335925 Issued in NY
Practice address
1065 James St
Syracuse, NY 13203-2787
Phone
(518) 949-8608
NPI assigned
Jul 2, 2009
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335925 NY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401857 NY
Registered Nurse 163W00000X 424639 NY

Addresses

Primary practice location

1065 James St
Syracuse, NY 13203-2787

Mailing address

1065 James St
Syracuse, NY 13203-2787
Phone (518) 949-8608

Other practice location 1

210 Lansing St
Utica, NY 13501-2900
Phone (315) 735-1645

Other practice location 2

1 Atwell Rd
Cooperstown, NY 13326-1394
Phone (607) 547-3456

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
I20130604000446 NY Practitioner - Nurse Practitioner 1850539776 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
424639NYMDRegistered Nurse
335925NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Aug 27, 2018 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 27, 2018 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Aug 1, 2018 Accepting new patients
Rescue Mission of Utica, Inc. Past Accepting new patients
Gilbertsville-Mt. Upton Central School District Past Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

39 Linden Ave
Cooperstown, NY 13326
Phone (607) 547-8181

693 State Highway 51
Gilbertsville, NY 13776
Phone (607) 783-2207

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

65 Main St
Morris, NY 13808
Phone (607) 263-2619

4238 State Highway 8
New Berlin, NY 13411
Phone (607) 847-6050

179 N Broad St
Norwich, NY 13815
Phone (607) 337-4111

Interoperability endpoints

  • Direct secure messaging: susan.converse@rescuemissionofutica.chartmakerdirect.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1679702336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032787",
            "telephone_number": "518-949-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032787",
            "telephone_number": "518-949-8608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Lansing St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135012900",
            "country_code": "US",
            "telephone_number": "315-735-1645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "133261394",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONVERSE",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335925",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401857",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "424639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.