Individual provider Active NPI

Ali Nicole Pensero, CRNA

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1265719652
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
562532 Issued in NY
Practice address
1001 Main St Ste K3502
Buffalo, NY 14203-1009
Phone
(716) 323-6570
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 562532 NY Primary

Addresses

Primary practice location

1001 Main St Ste K3502
Buffalo, NY 14203-1009

Mailing address

1001 Main St # K-3502
Buffalo, NY 14203-1009
Phone (716) 323-6570

Other practice location 1

30 S Cayuga Rd
Williamsville, NY 14221-6728
Phone (716) 632-1088

Other names 1

  • Ali Skowron Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120430000401 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880856392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
State Un of Ny, Buffalo School of Dental Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians

Practice addresses (Care Compare)

2950 Elmwood Ave
Buffalo, NY 14217-1304
Phone (716) 323-6570

Hospital & facility affiliations

  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
562532NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesiology, PC CurrentSince Apr 1, 2020 Accepting new patients
Maple Gate Anesthesiologists, P.C. CurrentSince Jan 1, 2012 Accepting new patients

Locations

1001 Main St
Ste K3502
Buffalo, NY 14203
Phone (716) 323-6576

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

2568 Walden Ave
Ste 103
Cheektowaga, NY 14225

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

30 S Cayuga Rd
Williamsville, NY 14221

215 Klein Rd
Williamsville, NY 14221
Phone (716) 568-6100

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

Organizations & group practices 2

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 3

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": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1265719652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST # K-3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6570",
            "fax_number": "716-323-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE K3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 S Cayuga Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142216728",
            "country_code": "US",
            "telephone_number": "716-632-1088",
            "fax_number": "716-632-7842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENSERO",
        "first_name": "ALI",
        "middle_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "562532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALI",
            "last_name": "SKOWRON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.