Individual provider Active NPI

Terri J Doolittle, NP

  • Adult Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1750339321
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303043 Issued in NY
Practice address
5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone
(315) 251-3100
Fax
(315) 449-9923
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303043 NY Primary

Addresses

Primary practice location

5719 Widewaters Pkwy
Syracuse, NY 13214-1880

Mailing address

5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone (315) 251-3100

Other names 1

  • Terri J Scala Former name

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
I20100126000585 NY Practitioner - Nurse Practitioner 5698817849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310

5700 W Genesee St
Camillus, NY 13031-3200
Phone (315) 487-4876

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303043NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Sep 11, 2000 Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients

Locations

8324 Oswego Rd
Ste B
Liverpool, NY 13090
Phone (315) 418-4188

5496 E Taft Rd
Ste C
North Syracuse, NY 13212
Phone (315) 251-3232

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

5801 E Taft Rd
Syracuse, NY 13212
Phone (315) 418-4140

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750339321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLITTLE",
        "first_name": "TERRI",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "SCALA",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.