Individual provider Active NPI

Kaitlin Corona, FNP-C

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1861893497
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338752-1 Issued in NY
Practice address
413 Douglas St
Syracuse, NY 13203-1616
Phone
(315) 569-9475
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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 F338752-1 NY Primary

Addresses

Primary practice location

413 Douglas St
Syracuse, NY 13203-1616

Mailing address

4206 Fireside Dr
Liverpool, NY 13090-2321
Phone (315) 569-9475

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
I20150804004377 NY Practitioner - Nurse Practitioner 6608180641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates for Women'S Medicine PLLCGroup PAC ID 4880677400, 17 clinicians

Practice addresses (Care Compare)

792 /2 N Main St
North Syracuse, NY 13212-1670
Phone (315) 701-0500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338752NYMDInternal Medicine Physician
F338752-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates for Women'S Medicine PLLC CurrentSince Apr 26, 2021 Accepting new patients
Anesthesia Affiliate PC PastSince Feb 15, 2018 Accepting new patients

Locations

4302 Medical Center Dr
Ste 302
Fayetteville, NY 13066
Phone (315) 423-9722

792 N Main St
Ste 200B
North Syracuse, NY 13212
Phone (315) 634-1190

792 N Main St
Ste 100A
Syracuse, NY 13212

792 N Main St
Syracuse, NY 13212
Phone (315) 458-8700

Interoperability endpoints

  • Direct secure messaging: kaitlin.coronanp.awm@direct.awm.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1861893497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 FIRESIDE DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130902321",
            "telephone_number": "315-569-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 DOUGLAS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031616",
            "telephone_number": "315-569-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONA",
        "first_name": "KAITLIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338752-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.