Individual provider Active NPI

David Nelson Cooper

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1881248391
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402663-01 Issued in NY
Practice address
742 James St
Syracuse, NY 13203-2017
Phone
(315) 703-2800
Fax
(315) 703-2766
NPI assigned
Aug 1, 2019
Last updated
Aug 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402663-01 NY Primary

Addresses

Primary practice location

742 James St
Syracuse, NY 13203-2017

Mailing address

14661 Center Rd
Sterling, NY 13156-4161
Phone (315) 342-2058

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
I20191025001013 NY Practitioner - Nurse Practitioner 2567794456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oswego HospitalGroup PAC ID 4981686045, 59 clinicians

Practice addresses (Care Compare)

29 E Cayuga St
Suite 400
Oswego, NY 13126-1241
Phone (315) 326-3536

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F402663-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center CurrentSince Oct 23, 2016 Accepting new patients
St Joseph's Hospital Health Center CurrentSince Oct 23, 2016 Accepting new patients
Oswego Hospital CurrentSince Mar 23, 2020 Accepting new patients

Locations

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

29 E Cayuga St
Ste 400
Oswego, NY 13126
Phone (315) 326-3536

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

742 James St
Syracuse, NY 13203
Phone (315) 703-2700

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.

Hospital & facility affiliations 1

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1881248391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14661 CENTER RD",
            "city": "STERLING",
            "state": "NY",
            "postal_code": "131564161",
            "telephone_number": "315-342-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032017",
            "telephone_number": "315-703-2800",
            "fax_number": "315-703-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DAVID",
        "middle_name": "NELSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402663-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.