Individual provider Active NPI

Tina M Zeck, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1114500733
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347132 Issued in NY
Practice address
701 Seneca St Ste 646C
Buffalo, NY 14210-1351
Phone
(657) 237-2450
NPI assigned
May 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 347132 NY Primary

Addresses

Primary practice location

701 Seneca St Ste 646C
Buffalo, NY 14210-1351

Mailing address

129 Maryon Dr
Buffalo, NY 14220-2844
Phone (716) 698-1867

Other practice location 1

129 Maryon Dr
Buffalo, NY 14220-2844
Phone (716) 698-1867

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
I20240724004066 NY Order and Referring Only - Nurse Practitioner 1456753599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
347132NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tzeck@landmarkhealth-direct.org

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1114500733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MARYON DR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142202844",
            "telephone_number": "716-698-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SENECA ST STE 646C",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101351",
            "telephone_number": "657-237-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Maryon Dr",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142202844",
            "country_code": "US",
            "telephone_number": "716-698-1867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZECK",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.