Individual provider Active NPI

Brittany Nicole Roth, NP

  • Nurse Practitioner
  • East Syracuse, NY
National Provider Identifier
1902524556
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F349936 Issued in NY
Practice address
5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone
(315) 472-7504
Fax
(315) 634-4677
NPI assigned
Aug 19, 2022
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F349936 NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249

Mailing address

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone (315) 472-7504

Other practice location 1

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 472-7504

Other identifiers 1

IdentifierTypeStateIssuer
F349936OtherNP LICENSE

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
I20221222001959 NY Practitioner - Nurse Practitioner 9537539143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
349936NYMDLicensed Practical Nurse
F349936NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology-Oncology Associates of Cny, PC Nurse Practitioner CurrentSince Sep 26, 2022 Accepting new patients

Locations

5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 634-5056

5008 Brittonfield Pkwy
Ste 700
East Syracuse, NY 13057

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Organizations & group practices 1

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1902524556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Broad Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132152265",
            "country_code": "US",
            "telephone_number": "315-472-7504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F349936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "F349936",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.