NPIMap

Individual provider Active NPI

Jennifer Rose Vanderwerf, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1376101741
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PENDING Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-4166
Fax
(716) 645-9701
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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 PENDING NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

100 Pinehurst Ave
Cheektowaga, NY 14225-3317
Phone (520) 820-2824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, OK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190814003240 NY Practitioner - Physician Assistant 4183951015 Reassigns benefits to 1 organization
I20240722001965 OK Practitioner - Physician Assistant 4183951015 Reassigns benefits to 1 organization
I20250417000251 TX Practitioner - Physician Assistant 4183951015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

508 Hwy 271 N
Antlers Community Clinic
Antlers, OK 74523
Phone (539) 316-6391

One Choctaw Way
Talihina, OK 74571-2022

Hospital & facility affiliations

  • Choctaw Nation Health Services Authority Hospital, Talihina, OK, CCN 370172

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
76.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5303OKMDGeneral Practice Dentistry
PENDINGNYMDInternal Medicine Physician
023546NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Apr 14, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Apr 14, 2025 Accepting new patients
Oklahoma State University CurrentSince Jul 1, 2024 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients
State of Oklahoma Past Accepting new patients

Locations

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

508 Highway 271 N
Antlers, OK 74523
Phone (580) 326-9725

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

Dept 2563
Tulsa, OK 74182

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

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.

Hospital & facility affiliations 11

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1376101741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PINEHURST AVE",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142253317",
            "telephone_number": "520-820-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4166",
            "fax_number": "716-645-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWERF",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.