Individual provider Active NPI

Beth Wlodarek

  • Physician Assistant
  • Dunkirk, NY
National Provider Identifier
1356317341
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0107521 Issued in NY
Practice address
504 Central Ave Ste 1
Dunkirk, NY 14048-2515
Phone
(716) 366-9008
Fax
(716) 363-0445
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0107521 NY Primary

Addresses

Primary practice location

504 Central Ave Ste 1
Dunkirk, NY 14048-2515

Mailing address

504 Central Ave Ste 1
Dunkirk, NY 14048-2515
Phone (716) 366-9008

Other practice location 1

12 Center St
Suite #1
Fredonia, NY 14063-1769
Phone (716) 679-2233

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address beth.wlodarek@upmcdirect.com

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
I20051115000809 NY Practitioner - Physician Assistant 5193744761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

31 Sherman St
Suite 2400
Jamestown, NY 14701-7082
Phone (814) 483-5306

504 Central Ave
Dunkirk, NY 14048-2515
Phone (716) 366-9008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0107521NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Area Medical Associates, L.L.P. CurrentSince Jun 1, 1997 Accepting new patients

Locations

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

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 4

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1356317341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CENTRAL AVE STE 1",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482515",
            "telephone_number": "716-366-9008",
            "fax_number": "716-363-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 CENTRAL AVE STE 1",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482515",
            "telephone_number": "716-366-9008",
            "fax_number": "716-363-0445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Center St",
            "address_2": "SUITE #1",
            "address_purpose": "LOCATION",
            "city": "Fredonia",
            "state": "NY",
            "postal_code": "140631769",
            "country_code": "US",
            "telephone_number": "716-679-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WLODAREK",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-01-25",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0107521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beth.wlodarek@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

Verify at the official NPI Registry.