Individual provider Active NPI

Maureen Nardozza

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1700513140
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F404173-01 Issued in NY
Practice address
4900 Broad Rd
Syracuse, NY 13215-2265
Phone
(315) 492-5011
NPI assigned
Aug 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F404173-01 NY Primary

Addresses

Primary practice location

4900 Broad Rd
Syracuse, NY 13215-2265

Mailing address

3404 Hammocks Dr Apt 208
Baldwinsville, NY 13027-4220
Phone (315) 209-9566

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
I20230202002189 NY Practitioner - Nurse Practitioner 5799157640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians
Psychiatric NP Consultants of Central New York, PLLCGroup PAC ID 6709143191, 7 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 464-3265

4914 W Genesee St
Suite 121
Camillus, NY 13031-2378
Phone (315) 446-1435

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
94.28 of 100Reported as group
Quality
88.2
Promoting interoperability
100
Improvement activities
40
Cost
69.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F404173-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Community Medical, PC CurrentSince Nov 28, 2022 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Psychiatric NP Consultants of Central New York, PLLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients

Locations

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

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

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

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

Interoperability endpoints

  • Direct secure messaging: mnardozza17670@direct.upstate.edu

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.

Hospital & facility affiliations 1

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1700513140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 HAMMOCKS DR APT 208",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130274220",
            "telephone_number": "315-209-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARDOZZA",
        "first_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404173-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.