Individual provider Active NPI

Matthew Andrew Holbok, FNP

  • Family Nurse Practitioner
  • North Syracuse, NY
National Provider Identifier
1790534584
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351877 Issued in NY
Practice address
5496 E Taft Rd Ste a
North Syracuse, NY 13212-3780
Phone
(315) 552-6700
Fax
(315) 552-6701
NPI assigned
May 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 351877 NY Primary

Addresses

Primary practice location

5496 E Taft Rd Ste a
North Syracuse, NY 13212-3780

Mailing address

PO Box 510
Syracuse, NY 13214-0510
Phone (315) 703-3484

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
I20260430000752 NY Practitioner - Nurse Practitioner 1456828110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5496 E Taft Rd
Suite a
North Syracuse, NY 13212-3780
Phone (315) 552-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
351877NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York Anesthesiology Medical Specialties PC CurrentSince Mar 22, 2026 Accepting new patients
New York Anesthesiology Medical Specialties, PC PastSince Mar 22, 2026 Accepting new patients

Locations

5496 E Taft Rd
Ste A
Syracuse, NY 13212
Phone (315) 552-6700

Organizations & group practices 2

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": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1790534584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132140510",
            "telephone_number": "315-703-3484",
            "fax_number": "315-703-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD STE A",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123780",
            "telephone_number": "315-552-6700",
            "fax_number": "315-552-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBOK",
        "first_name": "MATTHEW",
        "middle_name": "ANDREW",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.