Individual provider Active NPI

Alexandria Schultz, PAC

  • Internal Medicine Physician
  • Lackawanna, NY
National Provider Identifier
1376091082
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
020078 Issued in NY
Practice address
2600 S Park Ave
Lackawanna, NY 14218-1504
Phone
(716) 822-2028
Fax
(716) 822-2029
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 020078 NY Primary

Addresses

Primary practice location

2600 S Park Ave
Lackawanna, NY 14218-1504

Mailing address

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4381

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
I20161209000748 NY Practitioner - Physician Assistant 5799065728 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020078NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
Trinity Medical Wny PC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Trinity Medical Wny PC CurrentSince Oct 1, 2019 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

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

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

192 Park Club Ln
Ste 100
Williamsville, NY 14221
Phone (716) 667-7463

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1376091082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4381",
            "fax_number": "716-923-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S PARK AVE",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181504",
            "telephone_number": "716-822-2028",
            "fax_number": "716-822-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "ALEXANDRIA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "020078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

Verify at the official NPI Registry.