Individual provider Active NPI

Kathleen A Ruggiero

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1205870177
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334812-1 Issued in NY
Practice address
3435 Bailey Ave
Buffalo, NY 14215-1145
Phone
(716) 835-2966
Fax
(716) 834-3901
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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 F334812-1 NY Primary

Addresses

Primary practice location

3435 Bailey Ave
Buffalo, NY 14215-1145

Mailing address

3435 Bailey Ave
Buffalo, NY 14215-1145
Phone (716) 835-2966

Other identifiers 1

IdentifierTypeStateIssuer
02777104MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F334812-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1205870177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966",
            "fax_number": "716-834-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966",
            "fax_number": "716-834-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334812-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02777104",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.