Individual provider Active NPI

Ellen D Fitch, N.P.

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1104104710
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336839 Issued in NY
Practice address
831 Maple Rd
Williamsville, NY 14221-3267
Phone
(716) 565-1978
NPI assigned
Jul 31, 2011
Last updated
Sep 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336839 NY Primary

Addresses

Primary practice location

831 Maple Rd
Williamsville, NY 14221-3267

Mailing address

831 Maple Rd
Williamsville, NY 14221-3267
Phone (716) 565-1978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151006002260 NY Practitioner - Nurse Practitioner 9234447590 Reassigns benefits to 1 organization
I20250828003024 NY Practitioner - Hematology/Oncology 9234447590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
State University of Ny Upstate Medical University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336839NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Hematology-Oncology Associates of Cny, PC CurrentSince Aug 15, 2025 Accepting new patients
Suburban Cardiology,P.C. Past Accepting new patients

Locations

5490 Cobbler Way
Camillus, NY 13031

5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 634-5056

5008 Brittonfield Pkwy
Ste 700
East Syracuse, NY 13057

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Organizations & group practices 5

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": "1312070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1104104710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213267",
            "telephone_number": "716-565-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213267",
            "telephone_number": "716-565-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "ELLEN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-31",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.