Individual provider Active NPI

Marie Mastrangelo, ANP

  • Adult Health Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1457005001
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310686 Issued in NY
Practice address
3675 Southwestern Blvd
Orchard Park, NY 14127-1732
Phone
(716) 972-0279
NPI assigned
Feb 11, 2022
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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 310686 NY Primary

Addresses

Primary practice location

3675 Southwestern Blvd
Orchard Park, NY 14127-1732

Mailing address

3675 Southwestern Blvd
Orchard Park, NY 14127-1732
Phone (716) 972-0279

Other identifiers 1

IdentifierTypeStateIssuer
310686OtherNYNYS LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mastrangelom@southwesternmedical.medentdirect.com Health Information Exchange (HIE)
Direct Messaging Address mastrangelom@southwesternmedical.medentdirect.com Health Information Exchange (HIE)

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
I20220307001496 NY Practitioner - Nurse Practitioner 5991199069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highgate Medical Group PCGroup PAC ID 6901885565, 58 clinicians

Practice addresses (Care Compare)

3950 E Robinson Rd
Suite 207
Buffalo, NY 14228-2044
Phone (716) 564-1111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highgate Medical Group CurrentSince Aug 13, 2023 Accepting new patients
Highgate Medical Group CurrentSince Aug 13, 2023 Accepting new patients

Locations

3950 E Robinson Rd
Ste 207
West Amherst, NY 14228
Phone (716) 564-1111

3950 E Robinson Rd
Ste 305
West Amherst, NY 14228

6255 Sheridan Dr
Ste 200
Williamsville, NY 14221
Phone (716) 636-7979

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

Interoperability endpoints

  • Direct secure messaging: mmastrangelo@highgatemedical.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": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1457005001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271732",
            "telephone_number": "716-972-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271732",
            "telephone_number": "716-972-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRANGELO",
        "first_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "310686",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mastrangelom@southwesternmedical.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "medent direct",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hie",
            "address_1": "3675 Southwestern Blvd",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mastrangelom@southwesternmedical.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "medent",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wny healthelink",
            "address_1": "3675 Southwestern Blvd",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.