Individual provider Active NPI

Alexis Stachowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1033598677
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
602988 Issued in NY
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 836-7510
NPI assigned
May 28, 2015
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 602988 NY Primary
Registered Nurse 163W00000X RN.0204951 CO

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

3871 Harlem Rd Ste 202
Buffalo, NY 14215-1946
Phone (716) 836-7510

Other practice location 1

2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone (716) 836-7510 ext. 106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522001794 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991128779 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.0204951COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northtowns Ambulatory Surgery Center, LLC CurrentSince Sep 21, 2024 Accepting new patients
Buffalo Surgery Center LLC CurrentSince Apr 10, 2023 Accepting new patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients

Locations

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

3921 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6520

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

111 N Maplemere Rd
Williamsville, NY 14221
Phone (716) 636-8284

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1033598677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 HARLEM RD STE 202",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151946",
            "telephone_number": "716-836-7510",
            "fax_number": "716-832-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-836-7510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Cheektowaga",
            "state": "NY",
            "postal_code": "142254018",
            "country_code": "US",
            "telephone_number": "716-836-7510 x106",
            "fax_number": "716-832-3540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACHOWSKI",
        "first_name": "ALEXIS",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "602988",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0204951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.