Jacquelyn Anne Botticelli, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

30-304311 Issued in NY

Practice address

60 Innsbruck Dr
Buffalo, NY 14227-2735

Phone

(716) 668-7051

Fax

(716) 669-7069

NPI assigned

Jul 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Marcelo B. Corpuz Jr MD PC

  • Cardiovascular Disease Physician
  • Pittsburgh, PA
  • NPI 1528168531
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1356349740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 WALDEN AVE.",
            "address_2": "SUITE 110",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "14043",
            "telephone_number": "716-668-7051",
            "fax_number": "716-669-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 INNSBRUCK DR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142272735",
            "telephone_number": "716-668-7051",
            "fax_number": "716-669-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTICELLI",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30-304311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9515444",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03061112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Boswell, FNP
• Katelyn Bothwell, DO
• Shirley Botros, DO
• Julie Botsford, RN
• Kenneth Bott, RN
• Joan Marie Bottita, LPN
• Janette Helen Botzenhart, C.A.S.A.C.
• George Boucher, MD
• Stephanie Lowry Bouknight, RN
• Elyssa E Bourke, D.C.

• Adult Health Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.