Active NPI
Jenna Anne Richey, NP
- Adult Health Nurse Practitioner
- Depew, NY
National Provider Identifier
1184342719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 310797
- Practice address
- 571 Terrace Blvd
Depew, NY 14043-3610 - Phone
- (716) 683-4196
- Fax
- (716) 646-0763
- NPI assigned
- Aug 19, 2022
- Last updated
- Aug 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 310797 | NY | Primary |
Addresses
Primary practice location
571 Terrace Blvd
Depew, NY 14043-3610
Mailing address
4855 Camp Rd Ste 100
Hamburg, NY 14075-2600
Phone (716) 646-1084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310797 | Other | NY | NEW YORK STATE DEPT OF EDUCATION |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rwitulski@lakeshorepca.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
571 Terrace Blvd
Depew, NY 14043-3610
Phone (716) 683-4196
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 310797 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Primary Care Associates LLP | Current | Accepting new patients |
Locations
571 Terrace Blvd
Depew, NY 14043
Phone (716) 683-4196
4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084
Interoperability endpoints
- jrichey@lakeshorepca.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Hamburg, NY
- NPI 1225250525
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Millard Fillmore Suburban Hospital
- General Acute Care Hospital
- Williamsville, NY
- NPI 1053441907
-
dba Golisano Children's Hospital of Buffalo
- General Acute Care Hospital
- Buffalo, NY
- NPI 1245365196
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1366473183
-
dba Millard Fillmore Gates Hospital
- General Acute Care Hospital
- Buffalo, NY
- NPI 1831229780
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1790727543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1184342719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4855 CAMP RD STE 100",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140752600",
"telephone_number": "716-646-1084",
"fax_number": "716-646-0763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 TERRACE BLVD",
"city": "DEPEW",
"state": "NY",
"postal_code": "140433610",
"telephone_number": "716-683-4196",
"fax_number": "716-646-0763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHEY",
"first_name": "JENNA",
"middle_name": "ANNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "310797",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE DEPT OF EDUCATION",
"identifier": "310797",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rwitulski@lakeshorepca.com",
"affiliation": "N",
"endpointDescription": "Billing Manager business email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "html",
"address_1": "571 Terrace Blvd",
"city": "Depew",
"state": "NY",
"country_code": "US",
"postal_code": "140433610",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Depew, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.