Individual provider Active NPI

Melissa Lynn Gervais, NP-C

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1831665454
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F308944-1 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 448-6253
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F308944-1 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807

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
I20190115003763 NY Practitioner - Nurse Practitioner 3072859842 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

725 Irving Ave
Suite 314
Syracuse, NY 13210-1685
Phone (315) 464-9360

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307
  • Wynn Hospital Hospital, Utica, NY, CCN 330044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F308944-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Service Group CurrentSince Dec 1, 2022 Accepting new patients
St. Joseph'S Pathology, PC Current Accepting new patients
St Joseph'S Hospital Health Center CurrentSince Jan 28, 2019 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Dec 1, 2022 Accepting new patients
St Josephs Medical PC CurrentSince Dec 18, 2018 Accepting new patients
North Medical PC Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Jan 28, 2019 Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

725 Irving Ave
Ste 314
Syracuse, NY 13210
Phone (315) 424-0151

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: mgervais52294@direct.upstate.edu

Organizations & group practices 7

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 3

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1831665454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERVAIS",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F308944-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.