Individual provider Active NPI

Robert C Dundon Jr., FNP

  • Family Nurse Practitioner
  • Alden, NY
National Provider Identifier
1376970632
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338322 Issued in NY
Practice address
12705 Uebelhoer Rd
Alden, NY 14004
Phone
(716) 983-6079
NPI assigned
Oct 2, 2013
Last updated
Sep 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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 338322 NY Primary

Addresses

Primary practice location

12705 Uebelhoer Rd
Alden, NY 14004

Mailing address

3925 Sheridan Dr
Ste 100
Amherst, NY 14226-1738
Phone (716) 250-6492

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
I20141024001848 NY Practitioner - Nurse Practitioner 3072734516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
89.94
Promoting interoperability
88
Improvement activities
40
Cost
82.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338322NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Oct 1, 2019 Accepting new patients
Excelsior Orthopaedics LLP CurrentSince Oct 1, 2019 Accepting new patients

Locations

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

3925 Sheridan Dr
Ste 100
Buffalo, NY 14226
Phone (716) 250-6492

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

8750 Transit Rd
Ste 120
East Amherst, NY 14051
Phone (716) 568-1251

6133 Route 219 S
Ste 1001
Ellicottville, NY 14731
Phone (716) 636-1470

Interoperability endpoints

  • Direct secure messaging: rdundon@excelsiorortho.medentdirect.com

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, 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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1376970632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "address_2": "STE 100",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-6492",
            "fax_number": "716-250-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12705 UEBELHOER RD",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "14004",
            "telephone_number": "716-983-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNDON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alden, NY

Sources for this page

Verify at the official NPI Registry.