MRS. MACKENZIE RENEE ROTELLA (NPI# 1093268153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093268153 |
| Entity Type | Individual |
| Full Name | MRS. MACKENZIE RENEE ROTELLA |
| Credential | NP-C |
| Practice Address |
739 Irving Ave Suite 200 Syracuse NY 13210-1651 |
| Practice Telephone | 3154795070 |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
F340681-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
739 IRVING AVE SUITE 200 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384004 | Brenda A Baker | Nurse Practitioner | 739 Irving Ave, Ste 520, Syracuse, NY 13210-1663 | 2005-05-31 |
| 1538604053 | Darren Kwee | Physician Assistant | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2016-12-20 |
| 1811348642 | Sara Finney | Physician Assistant | 739 Irving Ave, Suite 600, Syracuse, NY 13210-1651 | 2016-06-22 |
| 1174990592 | Anna Buckman | Nurse Practitioner | 739 Irving Ave, Suite 500, Syracuse, NY 13210-1651 | 2015-09-02 |
| 1073999769 | Carly Hornis | Obstetrics & Gynecology | 739 Irving Ave, Suite 530, Syracuse, NY 13210-1663 | 2015-08-04 |
| 1144604117 | Brandy Leary | Nurse Practitioner | 739 Irving Ave, Suite 450, Syracuse, NY 13210-1651 | 2015-07-19 |
| 1639559305 | Crouse Medical Practice Pllc | Internal Medicine | 739 Irving Ave, Suite 500, Syracuse, NY 13210-1651 | 2015-06-08 |
| 1477950400 | Tabatha Jorgensen | Physician Assistant | 739 Irving Ave, Suite 600, Syracuse, NY 13210-1651 | 2014-11-19 |
| 1568874881 | Crouse Medical Practice Pllc | Non-Pharmacy Dispensing Site | 739 Irving Ave, Suite 200 and 300, Syracuse, NY 13210-1651 | 2014-05-21 |
| 1427487412 | Shikela Giles | Nurse Practitioner | 739 Irving Ave, Suite 200, Syracuse, NY 13210-1651 | 2013-11-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730670019 | Taralynn Kochanek | Nurse Practitioner | 4411 Abbey Rd, Syracuse, NY 13215-8733 | 2018-05-23 |
| 1801382338 | Emily Anne Weston | Nurse Practitioner | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2018-07-09 |
| 1649379397 | Maria Elizabeth Wheelock | Nurse Practitioner | 750 E Adams St, 314a Con, Syracuse, NY 13210-2306 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667169 | Noemi Villanueva Sta Ana | Nurse Practitioner | 1738 Newbridge Rd Unit 1, North Bellmore, NY 11710-1657 | 2020-10-24 |
| 1881292050 | Andrew Hirschhorn | Nurse Practitioner | 1435 Weaver St, Scarsdale, NY 10583-7018 | 2020-10-11 |
| 1154932036 | Brian Lorenzen | Nurse Practitioner | 25 Barker St Apt 513, Mount Kisco, NY 10549-1635 | 2020-08-13 |
| 1457961062 | Rosaleen Christine Galvin | Nurse Practitioner | 415 East 80th St, Apt. 1n, New York, NY 10075 | 2020-08-07 |
| 1477171684 | Rejane Duarte | Nurse Practitioner | 2600 Netherland Ave Ste 104, Bronx, NY 10463-4813 | 2020-07-14 |
| 1962029009 | Sharon Wu | Nurse Practitioner | 2426 W 3rd St, Brooklyn, NY 11223-5930 | 2020-07-05 |
| 1598381535 | Xue Qin Gao | Nurse Practitioner | 71-44 160th St. Unit 1, Flushing, NY 11365-3088 | 2020-06-24 |
| 1619590486 | Jan Jeremiah | Nurse Practitioner | 3839 Flatlands Ave Ste 100, Brooklyn, NY 11234-3535 | 2020-05-27 |
| 1205459534 | Shyan Indera Jagdeo | Nurse Practitioner | 645 W Broadway, Long Beach, NY 11561-2956 | 2020-05-21 |
| 1487276002 | Rosemary Elizabeth Carro | Nurse Practitioner | 21 Adams Farm Rd, Katonah, NY 10536-3166 | 2020-05-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.