Individual provider Active NPI

Jennifer Ann Phelan, FNP

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1275890279
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337049-1 Issued in NY
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-2260
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 F337049-1 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

5733 Lakeview Ter
Lake View, NY 14085-9735
Phone (716) 627-5501

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jphelan@direct.kaleidahealth.org Kaleida Health

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
I20120628000349 NY Practitioner - Nurse Practitioner 8628233400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

445 Tremont St
North Tonawanda, NY 14120-6150
Phone (716) 694-4500

818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 323-2000

900 Hertel Ave
Buffalo, NY 14216-2611
Phone (716) 871-1571

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F337049-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health Current Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

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

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

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 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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1275890279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5733 LAKEVIEW TER",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859735",
            "telephone_number": "716-627-5501"
        },
        {
            "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": "716-859-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337049-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jphelan@direct.kaleidahealth.org",
            "affiliation": "Y",
            "affiliationName": "Kaleida Health",
            "address_1": "100 High St",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142031126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.