Individual provider Active NPI

Elizabeth Anne Eaton, PA

  • Medical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1235606450
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
025295 Issued in NY
Practice address
665 Elm St
Buffalo, NY 14203-1104
Phone
(716) 845-2300
NPI assigned
Oct 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025295 NY
Medical Physician Assistant 363AM0700X 025295 NY Primary

Addresses

Primary practice location

665 Elm St
Buffalo, NY 14203-1104

Mailing address

66 Caswell Street
Lancaster, NY 14086
Phone (716) 474-7819

Other practice location 1

4267 Transit Rd
Williamsville, NY 14221-7205
Phone (716) 204-0798

Other practice location 2

Elm and Carlton St
Buffalo, NY 14263-1104
Phone (716) 845-2300

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
I20201104001042 NY Practitioner - Physician Assistant 9931519816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025295NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Jan 16, 2024 Accepting new patients
Erie County Medical Center Corporation CurrentSince Jan 16, 2024 Accepting new patients
Roswell Park Cancer Institute CurrentSince Sep 24, 2020 Accepting new patients

Locations

Elm and Carlton St
Buffalo, NY 14263

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

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1235606450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CASWELL STREET",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "14086",
            "telephone_number": "716-474-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 ELM ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031104",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4267 Transit Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142217205",
            "country_code": "US",
            "telephone_number": "716-204-0798",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Elm and Carlton St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142631104",
            "country_code": "US",
            "telephone_number": "716-845-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATON",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025295",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "025295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.