ELIZABETH A EVERGREEN FNP
NPI 1144846502
Nurse Practitioner - Family in Syracuse, NY

Q: What is Elizabeth Evergreen's NPI number?

The NPI number for Elizabeth Evergreen is 1144846502. It was assigned to this individual provider in the NPPES registry on June 22, 2020.

Q: What is Elizabeth Evergreen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since June 22, 2020PECOS EnrolledAccepts Medicare Assignment

930 S SALINA ST, SYRACUSE, NY 13202(315) 435-6266(315) 234-0465 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 12, 2024, Jun 22, 2020 (2 updates tracked since 2020).

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About Elizabeth A Evergreen Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH A EVERGREEN FNP (NPI 1144846502) is an individual family provider in Syracuse, New York, licensed in New York (345954) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1144846502

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameELIZABETH A EVERGREENCredential: FNP

Location Address930 S SALINA STSyracuse, NY 13202-3530

Mailing Address6846 Buckley RdNorth Syracuse, NY 13212-4275 · (315) 410-6400 · Fax (315) 410-6410

Phone(315) 435-6266

Fax(315) 234-0465

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJune 22, 2020

Last NPPES UpdateNovember 12, 20242 updates tracked since enumeration

NPPES CertifiedNovember 12, 2024

✔ NPI 1144846502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 345954

Also ListedClinical Nurse Specialist · Family HealthTaxonomy 364SF0001X · License 34594 (NY)

930 S SALINA ST, Syracuse, NY 13202

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Other Names 1

Former Name (1)Elizabeth Anne Randall Fnp-c

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elizabeth A Evergreen Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446677249

PECOS Enrollment IDI20200825001684

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYRACUSE COMMUNITY HEALTH CENTER

Clinic/Center (Federally Qualified Health Center (FQHC))