Individual provider Active NPI

Cory Damon

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1235758707
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309295-01 Issued in NY
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 908-1516
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F309295-01 NY
Adult Health Nurse Practitioner 363LA2200X F309295-01 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

8276 Greiner Rd
Buffalo, NY 14221-2817
Phone (716) 908-1516

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
I20210113002721 NY Practitioner - Nurse Practitioner 7911310875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 568-3600

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F309295-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
General Physician, PC CurrentSince Jul 1, 2024 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 23, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 23, 2020 Accepting new patients

Locations

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

100 High St
#D1
Buffalo, NY 14203
Phone (716) 422-0010

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

6199 Transit Rd
Depew, NY 14043
Phone (716) 206-0390

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

45 Spindrift Dr
Ste 100
Williamsville, NY 14221
Phone (716) 422-5422

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Interoperability endpoints

  • Direct secure messaging: cdamon@gppc.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1235758707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8276 GREINER RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142212817",
            "telephone_number": "716-908-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-908-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F309295-01",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309295-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.