Individual provider Active NPI

Mary Palmesano, N.P.

  • Nurse Practitioner
  • Corning, NY
National Provider Identifier
1689742165
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F420478-1 Issued in NY
Practice address
135 Walnut St
Corning, NY 14830-2545
Phone
(607) 962-4686
Fax
(607) 962-7520
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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 F420478-1 NY Primary

Addresses

Primary practice location

135 Walnut St
Corning, NY 14830-2545

Mailing address

314 W State St
Ithaca, NY 14850-5432
Phone (607) 273-1513

Other identifiers 1

IdentifierTypeStateIssuer
00362863MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F420478-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Greater New York Inc Past Accepting new patients

Organizations & group practices 1

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1689742165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-1513",
            "fax_number": "607-216-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WALNUT ST",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302545",
            "telephone_number": "607-962-4686",
            "fax_number": "607-962-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMESANO",
        "first_name": "MARY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F420478-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00362863",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.