Individual provider Active NPI

Jennifer Arnold, PA-C

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1104209238
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 Spindrift Dr Ste 100
Williamsville, NY 14221-7889
Phone
(716) 422-5422
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

45 Spindrift Dr Ste 100
Williamsville, NY 14221-7889

Mailing address

43 Basswood Dr
Cheektowaga, NY 14227-2608
Phone (716) 997-3036

Other identifiers 1

IdentifierTypeStateIssuer
04671349MedicaidNY

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
I20160112001503 NY Practitioner - Physician Assistant 4385952282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 884-3000

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

45 Spindrift Dr
Suite 100
Williamsville, NY 14221-7889
Phone (716) 422-5422

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jwojcik@gppc.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.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1104209238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 BASSWOOD DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142272608",
            "telephone_number": "716-997-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SPINDRIFT DR STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217889",
            "telephone_number": "716-422-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04671349",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.