Individual provider Active NPI

Jill Anderson Muntz, FNP

  • Family Nurse Practitioner
  • Jamestown, NY
National Provider Identifier
1407864267
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
332418 Issued in NY
Practice address
350 E 2ND St
Jamestown, NY 14701-5623
Phone
(716) 483-4373
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP011923 PA
Family Nurse Practitioner 363LF0000X 332418 NY Primary

Addresses

Primary practice location

350 E 2ND St
Jamestown, NY 14701-5623

Mailing address

197 Martin Rd
Jamestown, NY 14701-9224
Phone (716) 483-4376

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
I20100223000702 NY Practitioner - Nurse Practitioner 5092859470 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua County Chapter of Nysarc Inc. CurrentSince Oct 14, 2020 Accepting new patients
Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center Current Accepting new patients
Chautauqua County Chapter of Nysarc Inc Current Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Oct 14, 2020 Accepting new patients
Akl Medical PC PastSince Sep 29, 2019 Accepting new patients
Medicor Associates, Inc. Past Accepting new patients
Jamestown City School District PastSince Sep 27, 2020 Accepting new patients
Skyline Emergency Physicians, LLC Past Accepting new patients

Locations

350 E 2nd St
Jamestown, NY 14701
Phone (716) 483-3470

200 Dunham Ave
Jamestown, NY 14701
Phone (716) 661-1400

890 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1447

Interoperability endpoints

  • Direct secure messaging: jillmuntz@trc.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1407864267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 MARTIN RD",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019224",
            "telephone_number": "716-483-4376",
            "fax_number": "716-483-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 2ND ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015623",
            "telephone_number": "716-483-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTZ",
        "first_name": "JILL",
        "middle_name": "ANDERSON",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011923",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "332418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.