Individual provider Active NPI

Elliott Yadon, FNP-C

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1548641970
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342959 Issued in NY
Practice address
701 Seneca St Ste 646C
Buffalo, NY 14210-1351
Phone
(716) 995-4450
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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 95829 OK
Family Nurse Practitioner 363LF0000X F342959 NY Primary

Addresses

Primary practice location

701 Seneca St Ste 646C
Buffalo, NY 14210-1351

Mailing address

1150 Youngs Rd Ste 104
Williamsville, NY 14221-8096
Phone (716) 636-7979

Other practice location 1

1130 E Lansing St
Broken Arrow, OK 74012-2429
Phone (918) 258-9111

Other practice location 2

1150 Youngs Rd Ste 104
Williamsville, NY 14221-8096
Phone (716) 636-7979

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
I20180910000236 NY Practitioner - Nurse Practitioner 7416262878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
342959NYMDNeurological Surgery Physician
F342959NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concerto Care Medical Group of New York, PC CurrentSince Dec 23, 2024 Accepting new patients
Northeast Oklahoma Physician Network Inc PastSince Jul 21, 2015 Accepting new patients

Locations

50 Fountain Plz
Ste 1400
Buffalo, NY 14202
Phone (718) 504-9256

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIHBDD
  • Direct secure messaging: eyadon@landmarkhealth-direct.org

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1548641970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 YOUNGS RD STE 104",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218096",
            "telephone_number": "716-636-7979",
            "fax_number": "716-636-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SENECA ST STE 646C",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101351",
            "telephone_number": "716-995-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 E Lansing St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740122429",
            "country_code": "US",
            "telephone_number": "918-258-9111",
            "fax_number": "918-994-4277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 Youngs Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142218096",
            "country_code": "US",
            "telephone_number": "716-636-7979",
            "fax_number": "716-636-7993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YADON",
        "first_name": "ELLIOTT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "95829",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.