Individual provider Active NPI

Stephanie Lennore Eklind

  • Social Worker
  • Buffalo, NY
National Provider Identifier
1255970729
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112276 Issued in NY
Practice address
330 Delaware Ave
Buffalo, NY 14202-1868
Phone
(716) 842-2750
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Social Worker 104100000X 112276 NY Primary

Addresses

Primary practice location

330 Delaware Ave
Buffalo, NY 14202-1868

Mailing address

430 Niagara St
Buffalo, NY 14201-1886
Phone (716) 853-1335

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260323000718 NY Practitioner - Clinical Social Worker 1052895687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3901 Genesee St
Suite 300
Cheektowaga, NY 14225-1944

847 Washington St
Apartment 124
Buffalo, NY 14203-1219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112276NYMDSocial Worker

Organizations & group practices 1

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1255970729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142011886",
            "telephone_number": "716-853-1335",
            "fax_number": "716-853-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021868",
            "telephone_number": "716-842-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKLIND",
        "first_name": "STEPHANIE",
        "middle_name": "LENNORE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.