Individual provider Active NPI

Alexis C. Di Palma, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1326382631
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403058 Issued in NY
Practice address
400 Forest Ave BLDG 51
Buffalo, NY 14213-1207
Phone
(716) 816-2445
Fax
(716) 816-2357
NPI assigned
Nov 27, 2012
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403058 NY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 631277-1 NY

Addresses

Primary practice location

400 Forest Ave BLDG 51
Buffalo, NY 14213-1207

Mailing address

355 Central Ave
Fredonia, NY 14063-1132
Phone (716) 672-6117

Other identifiers 1

IdentifierTypeStateIssuer
146013200MedicaidNY

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
I20230731001032 NY Order and Referring Only - Nurse Practitioner 0840681565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
631277-1NYMDPsychiatric/Mental Health Registered Nurse
403058NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1326382631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CENTRAL AVE",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631132",
            "telephone_number": "716-672-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FOREST AVE BLDG 51",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131207",
            "telephone_number": "716-816-2445",
            "fax_number": "716-816-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI PALMA",
        "first_name": "ALEXIS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403058",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "631277-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146013200",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.