Individual provider Active NPI

Destiny S Ciemny, AGPCNP-BC DNP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1356809263
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309103-1 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3098
Phone
(716) 898-3000
NPI assigned
Mar 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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 F309103-1 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3098

Mailing address

6215 Tonawanda Creek Rd Apt 5
Lockport, NY 14094-7906
Phone (716) 628-8098

Other practice location 1

Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone (716) 845-2300

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
I20190617001558 NY Practitioner - Nurse Practitioner 3971836370 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

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

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219
  • Roswell Park Cancer Institute Hospital, Buffalo, NY, CCN 330354

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F309103-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Internist & Associates LLC CurrentSince May 7, 2019 Accepting new patients
Erie County Medical Center Corporation CurrentSince Jul 1, 2024 Accepting new patients
Roswell Park Cancer Institute CurrentSince Apr 30, 2020 Accepting new patients
Erie County Medical Center Corporation CurrentSince Jul 1, 2024 Accepting new patients
Roswell Park Cancer Institute CurrentSince Apr 30, 2020 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

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 5

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 2

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": "1552176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1356809263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 TONAWANDA CREEK RD APT 5",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140947906",
            "telephone_number": "716-628-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153098",
            "telephone_number": "716-898-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Elm and Carlton Streets",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142630001",
            "country_code": "US",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-8838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIEMNY",
        "first_name": "DESTINY",
        "middle_name": "S",
        "credential": "AGPCNP-BC DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-10",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309103-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.