Amber Modafferi, CRNA, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

138545 Issued in NY

Practice address

1001 West St
Carthage, NY 13619-9703

Phone

(315) 493-1000

NPI assigned

Dec 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

State licenses

Practice roles

Locations

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.

• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1053497388
  Medicare reassignment NPD
• Claxton-Hepburn Medical Center

  • Psychiatric Hospital
  • Ogdensburg, NY
  • NPI 1891753034
  Medicare reassignment NPD
• Carthage Area Hospital Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ogdensburg, NY
  • NPI 1013759166
  NPD
• Carthage Area Hospital, Inc.

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1891104717
  NPD

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1558021121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BRIDGE ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191352",
            "telephone_number": "315-561-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199703",
            "telephone_number": "315-493-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODAFFERI",
        "first_name": "AMBER",
        "credential": "CRNA, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "138545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Richard Meagher, DDS
• Cheyenne A Merry, LMHC-P
• Narmeen Minhas, DMD
• Mirza M Ashraf, M.D., P.C.
• Scott H Mitchell, M.D.
• Mulazim H Khan General Surgery PC
• Mulazim H.Khan General Surgery P.C.
• April Murphy, LMSW
• Sarenia Faith Murphy, OTR
• Andrew Nguyen, D.D.S.

• Certified Registered Nurse Anesthetist in Carthage, NY
• Providers in Carthage, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.