Individual provider Active NPI

Diane M Cozzo

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1215019930
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303508 Issued in NY
Practice address
85 High St
Buffalo, NY 14203-1149
Phone
(716) 857-8623
Fax
(716) 250-5907
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303508-1 NY
Adult Health Nurse Practitioner 363LA2200X 303508 NY Primary

Addresses

Primary practice location

85 High St
Buffalo, NY 14203-1149

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other identifiers 1

IdentifierTypeStateIssuer
02429216MedicaidNY

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
I20040312000894 NY Practitioner - Nurse Practitioner 1759270283 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F303508-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. CurrentSince Apr 9, 2019 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Apr 9, 2019 Accepting new patients
Lakeshore Primary Care Associates LLP CurrentSince Apr 19, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients
Mobile Physician Services PLLC PastSince Jan 1, 2015 Accepting new patients
Maria Rita Andaya M.D.,PLLC Past Accepting new patients
Horizon Health Services Inc PastSince Sep 1, 2019 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 7

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1215019930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031149",
            "telephone_number": "716-857-8623",
            "fax_number": "716-250-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COZZO",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303508-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02429216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.