NPIMap

Individual provider Active NPI

Jessica Elise Brown, PA

  • Physician Assistant
  • Kenmore, NY
National Provider Identifier
1477513034
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017770 Issued in NY
Practice address
2950 Elmwood Ave
Kenmore, NY 14217
Phone
(716) 447-6100
Fax
(716) 876-5079
NPI assigned
Mar 27, 2006
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017770 NY Primary

Addresses

Primary practice location

2950 Elmwood Ave
Kenmore, NY 14217

Mailing address

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

Other names 1

  • Jessica Elise Lightner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150313001539 NY Practitioner - Physician Assistant 5597786137 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kenmore Mercy HospitalGroup PAC ID 7517870462, 54 clinicians

Practice addresses (Care Compare)

2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone (716) 447-6100

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 297-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017770NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Mar 30, 2019 Accepting new patients
Kaleida Health CurrentSince Aug 8, 2020 Accepting new patients

Locations

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

2950 Elmwood Ave
#2
Buffalo, NY 14217

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

565 Abbott Rd
Ste 1
Buffalo, NY 14220

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1477513034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH 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": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "14217",
            "telephone_number": "716-447-6100",
            "fax_number": "716-876-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JESSICA",
        "middle_name": "ELISE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LIGHTNER",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kenmore, NY

Sources for this page

Verify at the official NPI Registry.