Individual provider Active NPI

Marissa Hawa Kapanek

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1538795083
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345395-01 Issued in NY
Practice address
2240 N Forest Rd
Buffalo, NY 14221-1357
Phone
(716) 639-4034
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345395-01 NY Primary

Addresses

Primary practice location

2240 N Forest Rd
Buffalo, NY 14221-1357

Mailing address

2240 North Forest Rd.
Williamsville, NY 14221
Phone (716) 639-4034

Other practice location 1

26 Culpepper Rd
Williamsville, NY 14221-3644
Phone (716) 361-3886

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melhawa@audubonwomens.medentdirect.com Health Information Exchange (HIE) Audubon Women's Medical Associates, PC

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
I20201224000330 NY Practitioner - Nurse Practitioner 9830501402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audubon Women'S Medical Associates, PCGroup PAC ID 9739083163, 13 clinicians

Practice addresses (Care Compare)

2240 N Forest Rd
Williamsville, NY 14221-1357
Phone (716) 639-4034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F345395-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon Women'S Medical Associates, PC CurrentSince Nov 16, 2020 Accepting new patients
Lori Badach,LCSW, PLLC PastSince Nov 16, 2020 Accepting new patients

Locations

2240 N Forest Rd
Williamsville, NY 14221
Phone (716) 331-0447

Interoperability endpoints

  • Direct secure messaging: mkapanek@audubonwomens.medentdirect.com
  • Direct secure messaging: melhawa@audubonwomens.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1538795083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 NORTH FOREST RD.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-639-4034",
            "fax_number": "716-929-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 N FOREST RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142211357",
            "telephone_number": "716-639-4034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Culpepper Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142213644",
            "country_code": "US",
            "telephone_number": "716-361-3886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPANEK",
        "first_name": "MARISSA",
        "middle_name": "HAWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345395-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melhawa@audubonwomens.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "Audubon Women's Medical Associates, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2240 N Forest Rd",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142211357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.