Individual provider Active NPI

Gina Fulater, NP

  • Family Nurse Practitioner
  • Lackawanna, NY
National Provider Identifier
1548644305
Registry record updated Jul 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338184-1 Issued in NY
Practice address
55 Melroy Ave
Lackawanna, NY 14218-1658
Phone
(716) 675-9724
NPI assigned
Jul 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2015

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 F338184-1 NY Primary

Addresses

Primary practice location

55 Melroy Ave
Lackawanna, NY 14218-1658

Mailing address

55 Melroy Ave
Lackawanna, NY 14218-1658

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
I20160201002422 NY Order and Referring Only - Nurse Practitioner 8628372380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F338184-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health System Program of All-Inclusive Care for the Elderly, Past Accepting new patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients

Organizations & group practices 3

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": "1436572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436572800000",
    "number": "1548644305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MELROY AVE",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MELROY AVE",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181658",
            "telephone_number": "716-675-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULATER",
        "first_name": "GINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-11",
        "last_updated": "2015-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338184-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

Verify at the official NPI Registry.