Individual provider Active NPI

Christopher Coccia, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1780988287
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341827 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210
Phone
(315) 470-7411
NPI assigned
Dec 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 602648-1 NY
Family Nurse Practitioner 363LF0000X 341827 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210

Mailing address

736 Irving Ave
Syracuse, NY 13210-1687

Other practice location 1

1409 Riverbend Dr
Baldwinsville, NY 13027-8626
Phone (315) 720-2047

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
I20170809003329 NY Practitioner - Nurse Practitioner 3678844669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
602648-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital Inc CurrentSince Jun 15, 2017 Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Jun 15, 2017 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": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1780988287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-470-7411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Baldwinsville",
            "state": "NY",
            "postal_code": "130278626",
            "country_code": "US",
            "telephone_number": "315-720-2047",
            "fax_number": "315-303-5301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCCIA",
        "first_name": "CHRISTOPHER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-27",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "602648-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.