NPIMap

Individual provider Active NPI

Alexis Hartmann, NP

  • Nurse Practitioner
  • Boonville, NY
National Provider Identifier
1922791425
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2458507 Issued in NY
Practice address
13460 State Route 12
Boonville, NY 13309-3531
Phone
(315) 942-4391
NPI assigned
May 31, 2023
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2458507 NY Primary
Registered Nurse 163W00000X 751282 NY

Addresses

Primary practice location

13460 State Route 12
Boonville, NY 13309-3531

Mailing address

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 801-8848

Other practice location 1

114 S Shore Rd
Old Forge, NY 13420-7786
Phone (315) 369-6619

Other names 1

  • Alexis Charbonneau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823001051 NY Practitioner - Nurse Practitioner 7416310560 Reassigns benefits to 1 organization

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
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

13460 State Route 12
Boonville, NY 13309-3531
Phone (315) 942-4391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
751282NYMDRegistered Nurse
2458507NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Sep 1, 2023 Accepting new patients
MVHS Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

13460 State Route 12
Boonville, NY 13309
Phone (315) 942-4391

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Interoperability endpoints

  • Direct secure messaging: acharbonneau11255@mvhealthsystem.direct-ci.com

Organizations & group practices 2

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 12

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1922791425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022517",
            "telephone_number": "315-801-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 STATE ROUTE 12",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133093531",
            "telephone_number": "315-942-4391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 S Shore Rd",
            "address_purpose": "LOCATION",
            "city": "Old Forge",
            "state": "NY",
            "postal_code": "134207786",
            "country_code": "US",
            "telephone_number": "315-369-6619",
            "fax_number": "315-369-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMANN",
        "first_name": "ALEXIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "2458507",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "751282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "CHARBONNEAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boonville, NY

Sources for this page

Verify at the official NPI Registry.