Individual provider Active NPI

Trudy Stern, NP

  • Adult Health Nurse Practitioner
  • N Tonawanda, NY
National Provider Identifier
1386782639
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F360120 Issued in NY
Practice address
533 Meadow Dr # 2
N Tonawanda, NY 14120-2835
Phone
(716) 692-3302
Fax
(716) 692-4342
NPI assigned
Feb 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F360120 NY Primary

Addresses

Primary practice location

533 Meadow Dr # 2
N Tonawanda, NY 14120-2835

Mailing address

908 Niagara Falls Blvd
Suite 208
N Tonawanda, NY 14120-2019
Phone (716) 692-3302

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
I20221212002445 NY Practitioner - Nurse Practitioner 3678942745 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F360120NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Jan 2, 2023 Accepting new patients
Academic Medicine Services, Inc. CurrentSince May 8, 2023 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Current Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Jan 2, 2023 Accepting new patients
Olivia Smith-Blackwell MD PC Past Accepting new patients

Locations

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 961-9900

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

301 Connecticut St
Buffalo, NY 14213
Phone (716) 862-2572

4498 Main St
Ste 23
Buffalo, NY 14226
Phone (716) 558-6629

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

Organizations & group practices 6

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386782639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD",
            "address_2": "SUITE 208",
            "city": "N TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 MEADOW DR # 2",
            "city": "N TONAWANDA",
            "state": "NY",
            "postal_code": "141202835",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "TRUDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F360120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.