NPIMap

Individual provider Active NPI

Suzanne Marie Fontecchio, CRNP

  • Nurse Practitioner
  • Erie, PA
National Provider Identifier
1962730507
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP010571 Issued in PA
Practice address
1330 W 26TH St
Erie, PA 16508-1402
Phone
(814) 459-9300
Fax
(814) 454-7780
NPI assigned
Nov 19, 2009
Last updated
Nov 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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 SP010571 PA Primary
Registered Nurse 163W00000X RN561265 PA

Addresses

Primary practice location

1330 W 26TH St
Erie, PA 16508-1402

Mailing address

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 459-9300

Other names 1

  • Suzanne Marie Heynoski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100601000432 PA Practitioner - Nurse Practitioner 5496884470 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millcreek Community HospitalGroup PAC ID 8426020173, shared by 24 NPIs, 67 clinicians

Practice addresses (Care Compare)

2222 W Grandview Blvd
Erie, PA 16506-4508
Phone (814) 454-3174

4740 Peach St
Erie, PA 16509-2008
Phone (814) 454-3174

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN561265PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Current Accepting new patients
Medical Associates of Erie CurrentSince Oct 14, 2022 Accepting new patients
Millcreek Community Hospital CurrentSince May 9, 2022 Accepting new patients
Millcreek Community Hospital Nurse Practitioner CurrentSince Mar 13, 2026 Accepting new patients
Medical Associates of Erie CurrentSince Oct 14, 2022 Accepting new patients
Millcreek Community Hospital CurrentSince May 9, 2022 Accepting new patients
Medical Associates of Erie Current Accepting new patients

Locations

1 Lecom Pl
Erie, PA 16505

2000 W Grandview Blvd
Erie, PA 16509
Phone (814) 868-1001

2222 W Grandview Blvd
Erie, PA 16506
Phone (814) 454-3174

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

4740 Peach St
Erie, PA 16509
Phone (814) 454-3174

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

Interoperability endpoints

  • Direct secure messaging: sfontecchio@maoeim-pa.direct.office.nextgen.com

Organizations & group practices 7

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 9

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1962730507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTECCHIO",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010571",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN561265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "HEYNOSKI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.