Jennifer Lee Tanner, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

015627 Issued in NY

Practice address

4845 Transit Rd
Suite T06
Depew, NY 14043-4783

Phone

(716) 391-0937

NPI assigned

Jun 22, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Buffalo Internal Medicine, PLLC

  • Hospitalist Physician
  • Kenmore, NY
  • NPI 1225204415
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1144583295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DELRAY AVE",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241841",
            "telephone_number": "716-698-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 TRANSIT RD",
            "address_2": "SUITE T06",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434783",
            "telephone_number": "716-391-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Superior Way Inc
• Marian Swanekamp, RPH
• Maureen Szuniewicz, OTR/L
• Walter R Szymanski, PT
• Olivia Marie Taneff
• Kristen Tasselmyer, MSW
• Elizabeth Thomas, PHARM.D.
• Katherine Thomas
• Evelyn E Thompson, PA-S
• Jamie Rager Tiberi, PT

• Physician Assistant in Depew, NY
• Providers in Depew, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.