Individual provider Active NPI

Jill Anne Koons, PNP

  • Pediatric Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1215201504
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382233 Issued in NY
Practice address
25 Hopkins Rd
Williamsville, NY 14221-4641
Phone
(716) 623-8050
Fax
(716) 632-2297
NPI assigned
Mar 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382233 NY Primary

Addresses

Primary practice location

25 Hopkins Rd
Williamsville, NY 14221-4641

Mailing address

25 Hopkins Rd
Williamsville, NY 14221-4641
Phone (716) 623-8050

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
I20191107001037 NY Practitioner - Nurse Practitioner 8325470651 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
382233NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Sep 14, 2019 Accepting new patients
Kaleida Health CurrentSince Sep 14, 2019 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health Current Accepting new patients
Amherst Pediatric Associates, P.C. Past Accepting new patients
Amherst Pediatric Associates, P.C. Past Accepting new patients

Locations

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

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

726 Exchange St
Ste 300
Buffalo, NY 14210
Phone (716) 859-8313

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

Organizations & group practices 6

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": "1330732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1215201504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HOPKINS RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214641",
            "telephone_number": "716-623-8050",
            "fax_number": "716-632-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOPKINS RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214641",
            "telephone_number": "716-623-8050",
            "fax_number": "716-632-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONS",
        "first_name": "JILL",
        "middle_name": "ANNE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-03",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.