Individual provider Active NPI

Alexandra Lee Mikolajek, DNP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1164080891
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
675212-1 Issued in NY
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 422-5815
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 675212-1 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

243 Waverly St
Springville, NY 14141-1055
Phone (716) 491-4883

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
I20190715002568 NY Practitioner - Nurse Practitioner 7517292493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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) 859-1400

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
675212-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jun 17, 2019 Accepting new patients

Locations

100 High St
#B2
Buffalo, NY 14203
Phone (716) 859-1256

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

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 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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1164080891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 WAVERLY ST",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "141411055",
            "telephone_number": "716-491-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-422-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAJEK",
        "first_name": "ALEXANDRA",
        "middle_name": "LEE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "675212-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.