Individual provider Active NPI

Amy Jeanene Munro, PA-C

  • Physician Assistant
  • Cheektowaga, NY
National Provider Identifier
1366447765
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008116-1 Issued in NY
Practice address
3884 Broadway
Cheektowaga, NY 14227-1104
Phone
(716) 981-9000
Fax
(716) 256-1079
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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 008116-1 NY Primary

Addresses

Primary practice location

3884 Broadway
Cheektowaga, NY 14227-1104

Mailing address

3884 Broadway
Cheektowaga, NY 14227-1104
Phone (716) 681-9000

Other identifiers 6

IdentifierTypeStateIssuer
0945293OtherNYCIGN
113653686118OtherNYTODAY'S OPTION
02345504MedicaidNY
1039551OtherNYWELLCARE
9776524OtherNYAETNA
PC139377OtherNYMVP

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
I20031204000841 NY Practitioner - Physician Assistant 3476458332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wny Medical PCGroup PAC ID 9335191733, 44 clinicians

Practice addresses (Care Compare)

3884 Broadway St
Cheektowaga, NY 14227-1104
Phone (716) 681-9000

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008116-1NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: amym@wnymedical.medentdirect.com

Organizations & group practices 1

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 3

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1366447765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3884 BROADWAY",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271104",
            "telephone_number": "716-681-9000",
            "fax_number": "716-256-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3884 BROADWAY",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271104",
            "telephone_number": "716-981-9000",
            "fax_number": "716-256-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNRO",
        "first_name": "AMY",
        "middle_name": "JEANENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008116-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGN",
            "identifier": "0945293",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TODAY'S OPTION",
            "identifier": "113653686118",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02345504",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1039551",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9776524",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "PC139377",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.