Individual provider Active NPI

Jeffrey Tinen

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1063073591
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
658202 Issued in NY
Practice address
3495 Bailey Ave
Buffalo, NY 14215-1129
Phone
(716) 834-9200
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 658202 NY Primary

Addresses

Primary practice location

3495 Bailey Ave
Buffalo, NY 14215-1129

Mailing address

3495 Bailey Ave
Buffalo, NY 14215-1129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929000365 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769889096 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
658202NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northtowns Ambulatory Surgery Center, LLC CurrentSince Dec 3, 2024 Accepting new patients
Endoscopy Center of Western New York LLC CurrentSince Sep 15, 2021 Accepting new patients

Locations

111 N Maplemere Rd
Williamsville, NY 14221
Phone (716) 713-4310

60 Maple Rd
#2
Williamsville, NY 14221
Phone (716) 332-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1063073591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-834-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINEN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "658202",
            "primary": true
        }
    ],
    "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 May 30, 2025; 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.