Individual provider Active NPI

Meaghan Primm, M.D.

  • Family Medicine Physician
  • Fulton, NY
National Provider Identifier
1992259451
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301075 Issued in NY
Practice address
522 S 4TH St
Fulton, NY 13069-2946
Phone
(315) 349-5511
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 301075 NY Primary

Addresses

Primary practice location

522 S 4TH St
Fulton, NY 13069-2946

Mailing address

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Other practice location 1

1525 Oak Park Blvd
Lake Charles, LA 70601-8849
Phone (337) 494-6767

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029002243 NY Practitioner - Family Practice 2163701343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Hospital & facility affiliations

  • Hospice of Central New York Hospice, Liverpool, NY, CCN 331511
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Care PC Family Medicine CurrentSince Oct 8, 2019 Accepting new patients
Oswego Hospital CurrentSince Apr 1, 2020 Accepting new patients

Locations

522 S 4th St
Ste 1700
Fulton, NY 13069
Phone (315) 592-3930

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Interoperability endpoints

  • Direct secure messaging: mprimm@hiemail.healtheconnections.org
  • Direct secure messaging: mprimm@oswegohealth.medentdirect.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1992259451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511",
            "fax_number": "315-349-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S 4TH ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692946",
            "telephone_number": "315-349-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018849",
            "country_code": "US",
            "telephone_number": "337-494-6767",
            "fax_number": "337-494-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIMM",
        "first_name": "MEAGHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

Verify at the official NPI Registry.