Individual provider Active NPI

Jenna Marie Walden

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1336846187
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311174-01 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-5209
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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 F311174-01 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

4254 Sheva LN
Hamburg, NY 14075-1315
Phone (716) 863-8701

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
I20230629000735 NY Practitioner - Nurse Practitioner 5597124263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219
  • Clifton Springs Hospital and Clinic Hospital, Clifton Springs, NY, CCN 330265
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
80.2
Improvement activities
40
Cost
72.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F311174-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince May 21, 2023 Accepting new patients
Erie County Medical Center Corporation CurrentSince May 21, 2023 Accepting new patients
Erie County Medical Center Corporation Past Accepting new patients

Locations

462 Grider St
Ste C113
Buffalo, NY 14215
Phone (716) 898-4899

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

Organizations & group practices 3

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 10

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1336846187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 SHEVA LN",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140751315",
            "telephone_number": "716-863-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311174-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.