Individual provider Active NPI

Christopher Damelio

  • Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1003696477
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F353265-01 Issued in NY
Practice address
565 Abbott Rd
Buffalo, NY 14220-2039
Phone
(716) 826-7000
NPI assigned
Oct 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F353265-01 NY Primary

Addresses

Primary practice location

565 Abbott Rd
Buffalo, NY 14220-2039

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240424003712 NY Practitioner - Nurse Practitioner 1355781303 Reassigns benefits to 1 organization
I20250327000320 NJ Practitioner - Nurse Practitioner 1355781303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Passaic River Observation, LLCGroup PAC ID 0143617126, 27 clinicians
Passaic River Physicians LLCGroup PAC ID 4486041514, 57 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F353265-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Passaic River Physicians, LLC CurrentSince Mar 1, 2025 Accepting new patients
Passaic River Physicians, LLC CurrentSince Mar 1, 2025 Accepting new patients
Buffalo Emergency Associates LLP CurrentSince Apr 11, 2024 Accepting new patients
Passaic River Observation, LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1003696477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142202039",
            "telephone_number": "716-826-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMELIO",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-03",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F353265-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.