Individual provider Active NPI

Shannon Marie Fortini, NP

  • Family Nurse Practitioner
  • West Seneca, NY
National Provider Identifier
1376233189
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351180 Issued in NY
Practice address
128 Knox Ave
West Seneca, NY 14224-1210
Phone
(716) 860-4834
NPI assigned
May 15, 2023
Last updated
Jan 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 351180 NY Primary

Addresses

Primary practice location

128 Knox Ave
West Seneca, NY 14224-1210

Mailing address

128 Knox Ave
West Seneca, NY 14224-1210
Phone (716) 860-4834

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
I20231221001974 NY Practitioner - Nurse Practitioner 2769832419 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 5, 2023 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 5, 2023 Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Past Accepting new patients

Locations

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

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1376233189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 KNOX AVE",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241210",
            "telephone_number": "716-860-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 KNOX AVE",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241210",
            "telephone_number": "716-860-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTINI",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.