Merle Cortellucci, M.S., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001767 Issued in NY

Practice address

4225 Genesee St
Buffalo, NY 14225-1994

Phone

(716) 829-6123

NPI assigned

Aug 12, 2020

Last updated

Aug 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1548871643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GENESEE ST",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 GENESEE ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142251994",
            "telephone_number": "716-829-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTELLUCCI",
        "first_name": "MERLE",
        "credential": "M.S., ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA",
            "identifier": "1009128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000000180",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonor Coronel
• Jerry L Corp II, PMHNP-BC
• Viera Corra, M.S. ED
• Renato Correa Viana Casarin
• William Corrin, PHARMD
• Priscilla Cortes, MHC
• Tammy Lee Cortes, FNP
• Matthew Joseph Cortese, MD, MPH
• Aunge Cory, LPC-MHSP, LCPC
• Matthew Cosmai, MSW

• Athletic Trainer in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.