Individual provider Active NPI

Susan Kreppel, NP

  • Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1376748640
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
304641 Issued in NY
Practice address
60 Maple Rd
Williamsville, NY 14221-2917
Phone
(716) 626-5250
Fax
(716) 332-2218
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 304641 NY Primary

Addresses

Primary practice location

60 Maple Rd
Williamsville, NY 14221-2917

Mailing address

60 Maple Rd
Williamsville, NY 14221-2917
Phone (716) 626-5250

Other identifiers 1

IdentifierTypeStateIssuer
02883232MedicaidNY

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
I20080505000452 NY Practitioner - Nurse Practitioner 7911086764

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wells Gastroenterology PLLC Past Accepting new patients
Gastrointestinal Group PastSince Jul 22, 2013 Accepting new patients

Organizations & group practices 2

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1376748640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREPPEL",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02883232",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.