Audrey A Mathis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F332143 Issued in NY

Practice address

4103 Medical Center Dr
Fayetteville, NY 13066-6600

Phone

(315) 637-7800

Fax

(315) 637-7808

NPI assigned

May 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Crouse Health Hospital Inc

  • Hospitalist Physician
  • Syracuse, NY
  • NPI 1841340205
  Medicare reassignment NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment NPD
• Emergency Care Services of New York, P.C.

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1639236656
  Medicare reassignment
• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD
• Central New York Cardiology, PC

  • Cardiovascular Disease Physician
  • Utica, NY
  • NPI 1750339412

  Family

  NPD (past)
• Atlantic Physician Services of Maryland, P.C.

  • Physician Assistant
  • Wilmington, DE
  • NPI 1730129594
  NPD (past)
• Atlantic Physician Services of Maryland, PC

  • Physician Assistant
  • Baltimore, MD
  • NPI 1174632376
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1740283829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7800",
            "fax_number": "315-637-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7800",
            "fax_number": "315-637-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "AUDREY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "320426",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02119060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marley M Rinoldo DDS PC
• Michaela Marotti, LMSW
• Emily M Marris, PA
• Mya Yvonne Martin, LMSW
• Tiera I Massey
• Tyler J Maxwell
• Joseph F McCaffrey, MD
• Lynne M McCawley, PT
• Sheila McGuire, NP
• Ashley Lynn McIntosh, NP

• Family Nurse Practitioner in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.