Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Sullivan

Individual provider Family Nurse Practitioner · NPI 1588354849

Amanda Sullivan is a Nurse Practitioner in Syracuse, New York. Graduated from State University of Ny Upstate Medical University in 2023, 3 years ago. Practices with St Josephs Medical PC, a 385-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2023
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Practice location Address checks out

301 Prospect Ave
Syracuse, NY 13203-1807
Phone: (315) 448-5871
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 752412 (NY)

Record details

NPI number1588354849
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 10, 2023
Last updated in NPPESOctober 20, 2025
Certification dateOctober 20, 2025
Mailing address301 Prospect Ave, Syracuse, NY 13203-1807

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 2023 (3 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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