Individual provider Active NPI

Dawn H. Degrasse, NP (NURSE PRACTITION

  • Adult Health Nurse Practitioner
  • West Amherst, NY
National Provider Identifier
1255756342
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306635 Issued in NY
Practice address
Tonawanda Medical Practice, P.C.
2800 Sweethome Rd. #6
West Amherst, NY 14228-1300
Phone
(716) 691-1300
Fax
(716) 691-5044
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306635 NY Primary

Addresses

Primary practice location

Tonawanda Medical Practice, P.C.
2800 Sweethome Rd. #6
West Amherst, NY 14228-1300

Mailing address

Tonawanda Medical Practice, P.C.
2800 Sweethome Rd. #6
West Amherst, NY 14228-1300
Phone (716) 691-1300

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
I20170119001186 NY Practitioner - Nurse Practitioner 3870808264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F306635NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1255756342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TONAWANDA MEDICAL PRACTICE, P.C.",
            "address_2": "2800 SWEETHOME RD. #6",
            "city": "WEST AMHERST",
            "state": "NY",
            "postal_code": "142281300",
            "telephone_number": "716-691-1300",
            "fax_number": "716-691-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TONAWANDA MEDICAL PRACTICE, P.C.",
            "address_2": "2800 SWEETHOME RD. #6",
            "city": "WEST AMHERST",
            "state": "NY",
            "postal_code": "142281300",
            "telephone_number": "716-691-1300",
            "fax_number": "716-691-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRASSE",
        "first_name": "DAWN",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "NP (NURSE PRACTITION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Amherst, NY

Sources for this page

Verify at the official NPI Registry.