Individual provider Active NPI

Rebecca Lea Wells, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1760013312
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F431656-01 Issued in NY
Practice address
Crouse Hospital
736 Irving Ave
Syracuse, NY 13210-1690
Phone
(315) 470-7111
NPI assigned
Feb 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F431656-01 NY Primary

Addresses

Primary practice location

Crouse Hospital
736 Irving Ave
Syracuse, NY 13210-1690

Mailing address

736 Irving Avenue
Syracuse, NY 13210-1690
Phone (315) 470-7111

Other names 1

  • Mrs. Rebecca Lea Wells-Stowe 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
I20220216001063 NY Practitioner - Nurse Practitioner 3577956572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

Hospital & facility affiliations

  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F431656-01NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Nov 16, 2021 Accepting new patients
Crouse Health Hospital Inc CurrentSince Nov 16, 2021 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients

Locations

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

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

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": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1760013312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101690",
            "telephone_number": "315-470-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CROUSE HOSPITAL",
            "address_2": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101690",
            "telephone_number": "315-470-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "REBECCA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F431656-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WELLS-STOWE",
            "middle_name": "LEA",
            "prefix": "MRS.",
            "credential": "AGACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.