Kristen Ann Tyrrell, NP
Individual provider Active NPI Family Nurse Practitioner · N Syracuse, NY
NPI 1891789707 · NPPES record last updated Nov 10, 2014
Key facts
- NPI
- 1891789707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F334097 (NY)
- Practice address
- 5180 W Taft Rd
N Syracuse, NY 13212-2601 - Phone
- (315) 458-4622
- Fax
- (315) 458-9629
- NPI assigned
- Sep 7, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Vermont College of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oswego Hospital
Practice addresses (Care Compare)
110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511
Hospital & facility affiliations
- Oswego Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070209000018 | NY | Practitioner - Nurse Practitioner | 2567464266 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F334097 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oswego Hospital | Current |
Accepting new patients | |
| St Josephs Medical PC | Current |
Accepting new patients | |
| North Medical PC | Current | Accepting new patients | |
| Patsy M Iannolo MD, PHD, P C | Past |
Accepting new patients |
Locations
5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592
110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511
61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274
301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200
301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111
104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442
301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F334097 | NY | Yes |
Addresses
Primary practice location
5180 W Taft Rd
N Syracuse, NY 13212-2601
Mailing address
PO Box 346
N Syracuse, NY 13212-0346
Phone (315) 458-4622
Other names
- Kristen Ann Miller
Other providers in N Syracuse, NY
- Suzanne M Lamanna DO PLLC
- Syracuse Hearing Aid Centers
- Syracuse Surgery Center, LLC
- Kristen Jean Taddie
- Tung D Nguyen DDS PC
- Helen Lucena Votra
- Walgreen Co
- Walk With Grace
- Adina Wyatt
- Michael John Zandri
All providers in N Syracuse, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.