Individual provider Active NPI

Samantha L. Chaderjian, FNP-C

  • Family Nurse Practitioner
  • Liverpool, NY
National Provider Identifier
1891575031
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F352039-01 Issued in NY
Practice address
5112 W Taft Rd
Liverpool, NY 13088-4868
Phone
(315) 701-2170
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 F352039-01 NY Primary

Addresses

Primary practice location

5112 W Taft Rd
Liverpool, NY 13088-4868

Mailing address

5112 West Taft Rd
Ste J
Liverpool, NY 13088
Phone (315) 701-2170

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
I20231129000999 NY Practitioner - Nurse Practitioner 8921456138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5112 W Taft Rd
Suite J
Liverpool, NY 13088-4866
Phone (315) 701-2170

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.56 of 100Reported as group
Quality
71.97
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F352039-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Service Group CurrentSince Dec 1, 2023 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Dec 1, 2023 Accepting new patients
Crouse Health Hospital Inc CurrentSince Oct 1, 2025 Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

510 Towne Dr
Fayetteville, NY 13066
Phone (315) 637-4747

5112 W Taft Rd
Ste J
Liverpool, NY 13088
Phone (315) 701-2170

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

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

Interoperability endpoints

  • Direct secure messaging: ssmith69558@direct.upstate.edu

Organizations & group practices 4

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 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": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1891575031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT RD",
            "address_2": "STE J",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-701-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 W TAFT RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884868",
            "telephone_number": "315-701-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADERJIAN",
        "first_name": "SAMANTHA",
        "middle_name": "L.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-11-06",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F352039-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.