Individual provider Active NPI

Nicole Converso, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1477753036
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3 Gates Cir
Buffalo, NY 14209-1120
Phone
(716) 887-5880
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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 NY Primary

Addresses

Primary practice location

3 Gates Cir
Buffalo, NY 14209-1120

Mailing address

41 Satinwood Dr
Cheektowaga, NY 14225-3715

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
I20071219000086 NY Practitioner - Physician Assistant 9931299633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

445 Tremont St
North Tonawanda, NY 14120-6150
Phone (716) 694-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health CurrentSince Aug 15, 2019 Accepting new patients
Wny Medical PC Physician Assistant Past Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

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

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1477753036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SATINWOOD DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142253715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GATES CIR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091120",
            "telephone_number": "716-887-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONVERSO",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.