Individual provider Active NPI

Gabrielle Mari Masse, FNP-C

  • Family Nurse Practitioner
  • Manlius, NY
National Provider Identifier
1760158885
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
348181 Issued in NY
Practice address
4440 Brickyard Falls Rd
Manlius, NY 13104-9572
Phone
(315) 552-4695
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 348181 NY Primary

Addresses

Primary practice location

4440 Brickyard Falls Rd
Manlius, NY 13104-9572

Mailing address

4440 Brickyard Falls Rd
Manlius, NY 13104-9572
Phone (315) 552-4695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
348181NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1760158885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 BRICKYARD FALLS RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049572",
            "telephone_number": "315-552-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BRICKYARD FALLS RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049572",
            "telephone_number": "315-552-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSE",
        "first_name": "GABRIELLE",
        "middle_name": "MARI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

Verify at the official NPI Registry.