Individual provider Active NPI

Anita Crawley, PNP

  • Pediatric Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1205919636
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F380702 Issued in NY
Practice address
1001 Main St FL 4
Buffalo, NY 14203-1009
Phone
(716) 323-0080
Fax
(716) 323-0295
NPI assigned
Oct 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 406983 NY
Pediatric Gastroenterology Physician 2080P0206X F380702 NY
Pediatric Nurse Practitioner 363LP0200X F380702 NY Primary

Addresses

Primary practice location

1001 Main St FL 4
Buffalo, NY 14203-1009

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0080

Other identifiers 6

IdentifierTypeStateIssuer
000560684001OtherNYBC/BS
00027166101OtherNYUNIVERA
02244484MedicaidNY
0018168500001OtherPA MEDICAID
5111042OtherNYIHA
040426002817OtherNYFIDELIS

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
I20050118000602 NY Practitioner - Nurse Practitioner 0143279000 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
406983NYMDRegistered Nurse
F380702NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc CurrentSince Dec 5, 2010 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

1404 Sweet Home Rd
Ste 5
Amherst, NY 14228
Phone (716) 639-9360

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

219 Bryant St
Buffalo, NY 14222
Phone (716) 878-7000

1400 Sweet Home Rd
Ste 5
Buffalo, NY 14228
Phone (716) 691-6283

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1205919636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0080",
            "fax_number": "716-323-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0080",
            "fax_number": "716-323-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWLEY",
        "first_name": "ANITA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "406983",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "F380702",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000560684001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00027166101",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02244484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAID",
            "identifier": "0018168500001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "5111042",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426002817",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.