Individual provider Active NPI

Mary Rose Altman, CNM

  • Midwife
  • Syracuse, NY
National Provider Identifier
1710969126
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F0003641 Issued in NY
Practice address
600 E Genesee St
Suite 323
Syracuse, NY 13202-3130
Phone
(315) 476-1645
Fax
(315) 476-5640
NPI assigned
Nov 19, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F0003641 NY Primary

Addresses

Primary practice location

600 E Genesee St
Suite 323
Syracuse, NY 13202-3130

Mailing address

600 E Genesee St
Suite 323
Syracuse, NY 13202-3130
Phone (315) 476-1645

Other identifiers 1

IdentifierTypeStateIssuer
01982787MedicaidNY

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
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F0003641NYMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710969126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 323",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-476-1645",
            "fax_number": "315-476-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 323",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-476-1645",
            "fax_number": "315-476-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "MARY ROSE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F0003641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01982787",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.