Individual provider Active NPI

Alicia McInerney, NP

  • Family Nurse Practitioner
  • Camillus, NY
National Provider Identifier
1962825257
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338329-1 Issued in NY
Practice address
250 Township Blvd Ste 10
Camillus, NY 13031-1674
Phone
(315) 928-7060
Fax
(315) 928-7060
NPI assigned
Jan 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 F338329-1 NY Primary

Addresses

Primary practice location

250 Township Blvd Ste 10
Camillus, NY 13031-1674

Mailing address

250 Township Blvd Ste 10
Camillus, NY 13031-1674
Phone (315) 928-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F338329-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marcellus Medical Group PLLC PastSince Feb 2, 2020 Accepting new patients
Familycare Medical Group, PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1962825257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 TOWNSHIP BLVD STE 10",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311674",
            "telephone_number": "315-928-7060",
            "fax_number": "315-928-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 TOWNSHIP BLVD STE 10",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311674",
            "telephone_number": "315-928-7060",
            "fax_number": "315-928-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINERNEY",
        "first_name": "ALICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.