Individual provider Active NPI

Krista Molison Clontz, ANP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1093955726
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
305074 Issued in NY
Practice address
85 High St
Buffalo
Buffalo, NY 14203-1149
Phone
(716) 630-1000
Fax
(716) 630-1054
NPI assigned
Feb 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 426857 NY
Adult Health Nurse Practitioner 363LA2200X 305074 NY Primary

Addresses

Primary practice location

85 High St
Buffalo
Buffalo, NY 14203-1149

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 630-1000

Other practice location 2

3900 N Buffalo Rd.
Williamsville, NY 14221
Phone (716) 630-1000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000140 NY Practitioner - Nurse Practitioner 7315091840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

85 High St
Buffalo, NY 14203-1149
Phone (716) 630-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.31 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
83.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305074NYMDObstetrics & Gynecology Physician
426857NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Nov 21, 2011 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Nov 21, 2011 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Sep 4, 2012 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Sisters of Charity Hospital of Buffalo, New York CurrentSince Sep 4, 2012 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

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

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

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

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

295 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1050

Organizations & group practices 6

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 6

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": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1093955726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "address_2": "BUFFALO",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031149",
            "telephone_number": "716-630-1000",
            "fax_number": "716-630-1054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Essjay Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142218216",
            "country_code": "US",
            "telephone_number": "716-630-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Buffalo Rd.",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "14221",
            "country_code": "US",
            "telephone_number": "716-630-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLONTZ",
        "first_name": "KRISTA",
        "middle_name": "MOLISON",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-20",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "426857",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.