MALLORY CONNER
NPI 1265030753
Nurse Practitioner - Psychiatric/Mental Health in Syracuse, NY

Q: What is Mallory Conner's NPI number?

The NPI number for Mallory Conner is 1265030753. It was assigned to this individual provider in the NPPES registry on October 15, 2020.

Q: What is Mallory Conner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Conner was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 15, 2020PECOS Enrolled

739 IRVING AVE STE 340, SYRACUSE, NY 13210(315) 479-5070 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 15, 2021, Nov 17, 2020, Oct 15, 2020 (3 updates tracked since 2020).

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About Mallory Conner NPPES

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

MALLORY CONNER (NPI 1265030753) is an individual psychiatric/mental health provider in Syracuse, New York, licensed in New York (2020011129) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265030753

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMALLORY CONNER

Location Address739 IRVING AVE STE 340Syracuse, NY 13210-1605

Mailing Address1001 W Fayette St Ste 400Syracuse, NY 13204-2866 · (315) 937-3433 · Fax (315) 937-3833

Phone(315) 479-5070

Sole ProprietorYes

Enumeration DateOctober 15, 2020

Last NPPES UpdateMarch 15, 20213 updates tracked since enumeration

NPPES CertifiedMarch 15, 2021

✔ NPI 1265030753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · 2020011129

739 IRVING AVE STE 340, Syracuse, NY 13210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Conner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mallory Conner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Crouse Medical Practice, PLLC

Same address

Internal Medicine

736 IRVING AVE
Syracuse, NY 13210

Reassigned Medicare billing, New York enrollment
159 clinicians in this Medicare group

NPI 1922321934 (315) 470-7375

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 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 10

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

MRS. TATYANA BELOUS PA

Physician Assistant