Active NPI
Courtney Hannon, PA-C
- Physician Assistant
- Williamsville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 36 N Union Rd
Williamsville, NY 14221-5383 - Phone
- (716) 710-7807
- Fax
- (716) 710-7808
- NPI assigned
- Feb 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
36 N Union Rd
Williamsville, NY 14221-5383
Mailing address
726 Exchange St Ste 710
Buffalo, NY 14210-1464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230329000666 | NY | Practitioner - Physician Assistant | 4082088281 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 N Union Rd
Williamsville, NY 14221-5367
Phone (716) 747-4000
36 N Union Rd
Williamsville, NY 14221-5383
Phone (716) 710-7807
Hospital & facility affiliations
- Kaleida Health
- Sisters of Charity Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029690 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Physician Care, PC | Current | Accepting new patients |
Locations
30 N Union Rd
Ste 101
Williamsville, NY 14221
Phone (716) 633-6363
30 N Union Rd
Williamsville, NY 14221
Phone (716) 633-6363
36 N Union Rd
Williamsville, NY 14221
Phone (716) 636-1470
Interoperability endpoints
- channonpa@premierhealthpartners.medentdirect.com
Organizations & group practices 1
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 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
Hospital
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1790727543
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1013613744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "726 EXCHANGE ST STE 710",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142101464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 N UNION RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142215383",
"telephone_number": "716-710-7807",
"fax_number": "716-710-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNON",
"first_name": "COURTNEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-03",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.