Individual provider Active NPI

Debra Ann Cardarelli, PMHNP,APRN,BC,LCSW

  • Psychiatric/Mental Health Nurse Practitioner
  • East Syracuse, NY
National Provider Identifier
1780738526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401033-1 Issued in NY
Practice address
5800 Heritage Landing Dr
East Syracuse, NY 13057-9378
Phone
(315) 472-7885
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

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
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401033-1 NY Primary

Addresses

Primary practice location

5800 Heritage Landing Dr
East Syracuse, NY 13057-9378

Mailing address

6436 Terese Ter
Jamesville, NY 13078-9430
Phone (315) 445-2178

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
I20070726000044 NY Practitioner - Nurse Practitioner 3173624723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dewitt Counseling Associates LCSW PCGroup PAC ID 3870765597, 2 clinicians

Practice addresses (Care Compare)

892 E Brighton Ave
Suite 2
Syracuse, NY 13205-2542
Phone (315) 472-7885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401033-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Janis L. Scaturo LCSW, P.C. Past Accepting new patients
Dewitt Counseling Services LCSW PC Psychiatric/Mental Health Past Accepting new patients
Barbara J. Miller, M.D., P.C. Past Accepting new patients
MH-Cny-FL Medical PC PastSince Jun 12, 2009 Accepting new patients

Organizations & group practices 5

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780738526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6436 TERESE TER",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "130789430",
            "telephone_number": "315-445-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HERITAGE LANDING DR",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579378",
            "telephone_number": "315-472-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDARELLI",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP,APRN,BC,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401033-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.