Individual provider Active NPI

Rebecca Jennifer Rensy-Tallarico, FNP

  • Family Nurse Practitioner
  • North Syracuse, NY
National Provider Identifier
1871992693
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338788 Issued in NY
Practice address
5496 E Taft Rd
North Syracuse, NY 13212-3784
Phone
(315) 552-6700
Fax
(315) 552-6701
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 338788 NY Primary

Addresses

Primary practice location

5496 E Taft Rd
North Syracuse, NY 13212-3784

Mailing address

17 Lansing Street
Auburn, NY 13021
Phone (315) 255-7438

Other identifiers 1

IdentifierTypeStateIssuer
03951388MedicaidNY

Other names 1

  • Mrs. Rebecca Jennifer Rensy Former name

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
I20141001001770 NY Practitioner - Nurse Practitioner 5698995330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-8093

77 Nelson St
Auburn, NY 13021-1941

77 Nelson St
Auburn, NY 13021-1944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Health Science Center at Syracuse Family CurrentSince Aug 22, 2024 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Aug 22, 2024 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Feb 1, 2023 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Feb 1, 2023 Accepting new patients
Auburn Community Hospital CurrentSince Jan 19, 2022 Accepting new patients
Auburn Community Hospital CurrentSince Jan 19, 2022 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

77 Nelson St
Ste 230
Auburn, NY 13021
Phone (315) 252-9562

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

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

Interoperability endpoints

  • Direct secure messaging: rrensytallarico@amms.medentdirect.com
  • Direct secure messaging: rrensytallarico160996@direct.upstate.edu

Organizations & group practices 6

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 2

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1871992693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING STREET",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-255-7438",
            "fax_number": "315-255-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-552-6700",
            "fax_number": "315-552-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENSY-TALLARICO",
        "first_name": "REBECCA",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03951388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "RENSY",
            "middle_name": "JENNIFER",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.