Individual provider Active NPI

Alexander Joseph Eller, NURSE PRACTIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Whitesboro, NY
National Provider Identifier
1740592344
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401301-1 Issued in NY
Practice address
238 Oriskany Blvd
Whitesboro, NY 13492-1540
Phone
(315) 768-7181
Fax
(315) 768-7182
NPI assigned
Jul 12, 2010
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401301-1 NY Primary
Registered Nurse 163W00000X 369122 NY

Addresses

Primary practice location

238 Oriskany Blvd
Whitesboro, NY 13492-1540

Mailing address

6682 Stage Rd
Utica, NY 13502-6912
Phone (315) 797-6728

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
I20120524000187 NY Practitioner - Nurse Practitioner 6406019793 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Hartford Psychiatric Services PLLCGroup PAC ID 4981590304, 5 clinicians

Practice addresses (Care Compare)

238 Oriskany Blvd
Whitesboro, NY 13492-1540
Phone (315) 768-7181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
369122NYMDRegistered Nurse
F401301-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
Charles T Sitrin Health Care Center, Inc CurrentSince Nov 27, 2016 Accepting new patients
New Hartford Psychiatric Services PLLC CurrentSince Apr 8, 2012 Accepting new patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
Charles T. Sitrin Health Care Center, Inc CurrentSince Nov 27, 2016 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Oct 1, 2016 Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

2050 Tilden Ave
New Hartford, NY 13413
Phone (315) 737-2466

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

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

238 Oriskany Blvd
Whitesboro, NY 13492
Phone (315) 768-7181

Interoperability endpoints

  • Direct secure messaging: alexander.eller@newhartfordpsychiatricservices.chartmakerdirect.com

Organizations & group practices 6

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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1740592344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6682 STAGE RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026912",
            "telephone_number": "315-797-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ORISKANY BLVD",
            "city": "WHITESBORO",
            "state": "NY",
            "postal_code": "134921540",
            "telephone_number": "315-768-7181",
            "fax_number": "315-768-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "ALEXANDER",
        "middle_name": "JOSEPH",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401301-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "369122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesboro, NY

Sources for this page

Verify at the official NPI Registry.