Individual provider Active NPI

Michael Rondenelli, FNP-C

  • Primary Care Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1861089146
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F346529-01 Issued in NY
Practice address
3504 W Genesee St Ste 1B
Syracuse, NY 13219-2012
Phone
(315) 401-0754
NPI assigned
Dec 21, 2020
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F346529-01 NY Primary

Addresses

Primary practice location

3504 W Genesee St Ste 1B
Syracuse, NY 13219-2012

Mailing address

107 Lueck LN
Liverpool, NY 13088-6115
Phone (315) 272-9361

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
I20210127000551 NY Practitioner - Nurse Practitioner 1759795198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

3504 W Genesee St
Suite 1B
Syracuse, NY 13219-2012
Phone (315) 401-0754

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F346529-01NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Feb 1, 2021 Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Empire Vision Center, Inc Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

3504 W Genesee St
Ste 1B
Syracuse, NY 13219
Phone (315) 401-0754

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1861089146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LUECK LN",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130886115",
            "telephone_number": "315-272-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 W GENESEE ST STE 1B",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192012",
            "telephone_number": "315-401-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDENELLI",
        "first_name": "MICHAEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F346529-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.