Individual provider Active NPI

Madonna Marie Reddington, FNP

  • Family Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1245519800
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336724-1 Issued in NY
Practice address
3900 N Buffalo St
Orchard Park, NY 14127
Phone
(716) 656-4988
Fax
(716) 817-1719
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336724-1 NY Primary

Addresses

Primary practice location

3900 N Buffalo St
Orchard Park, NY 14127

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-5782
Phone (716) 656-4988

Other practice location 1

2128 Elmwood Ave
Buffalo, NY 14207-1910
Phone (716) 874-4500

Other identifiers 1

IdentifierTypeStateIssuer
01465154MedicaidNY

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
I20110929000022 NY Practitioner - Nurse Practitioner 2466623376 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F336724-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. CurrentSince Jul 10, 2018 Accepting new patients
Statline Medical PC CurrentSince Oct 25, 2022 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jul 10, 2018 Accepting new patients

Locations

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

3245 Southwestern Blvd
Ste 100A
Orchard Park, NY 14127
Phone (716) 608-2226

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

451 Broad St
Salamanca, NY 14779
Phone (716) 945-1800

200 White Plains Rd
Ste 110
Tarrytown, NY 10591
Phone (914) 848-4343

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

Organizations & group practices 3

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1245519800",
    "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": "142215782",
            "telephone_number": "716-656-4988",
            "fax_number": "716-817-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-656-4988",
            "fax_number": "716-817-1719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2128 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142071910",
            "country_code": "US",
            "telephone_number": "716-874-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDINGTON",
        "first_name": "MADONNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336724-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.