Individual provider Active NPI

Jonathan Joseph Sicilia, NP

  • Family Medicine Physician
  • East Syracuse, NY
National Provider Identifier
1992363550
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F344407 Issued in NY
Practice address
4939 Brittonfield Pkwy Ste 101
East Syracuse, NY 13057-9208
Phone
(315) 463-1600
Fax
(315) 634-6793
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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 F344407 NY Primary

Addresses

Primary practice location

4939 Brittonfield Pkwy Ste 101
East Syracuse, NY 13057-9208

Mailing address

4939 Brittonfield Pkwy Ste 101
East Syracuse, NY 13057-9208
Phone (315) 634-6779

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
I20190712002662 NY Practitioner - Nurse Practitioner 1850626862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cny Family Care LLPGroup PAC ID 6901710896, 29 clinicians

Practice addresses (Care Compare)

4939 Brittonfield Pkwy
Suite 101
East Syracuse, NY 13057-9208
Phone (315) 463-1600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F344407NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Family Care, LLP Family Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

4939 Brittonfield Pkwy
Ste 101
East Syracuse, NY 13057
Phone (315) 463-1600

Interoperability endpoints

  • Direct secure messaging: jsicilia@cnyfamilycare.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1992363550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 101",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-634-6779",
            "fax_number": "315-634-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 101",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-463-1600",
            "fax_number": "315-634-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIA",
        "first_name": "JONATHAN",
        "middle_name": "JOSEPH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F344407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.