Individual provider Active NPI

Mary D Bierbrauer, RN

  • Diabetes Educator Registered Nurse
  • Amherst, NY
National Provider Identifier
1578852786
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
415468-1 Issued in NY
Practice address
3980 Sheridan Dr
6TH FL
Amherst, NY 14226-1727
Phone
(716) 882-6544
Fax
(716) 882-6833
NPI assigned
Mar 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 415468-1 NY Primary

Addresses

Primary practice location

3980 Sheridan Dr
6TH FL
Amherst, NY 14226-1727

Mailing address

77 Goodell St
Suite 320
Buffalo, NY 14203-1243
Phone (716) 816-7200

Other identifiers 3

IdentifierTypeStateIssuer
1578852786OtherNYBLUE CROSS
6516597OtherNYINDEPENDENT HEALTH
03338869MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
415468-1NYMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Academic Medicine Services, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1578852786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GOODELL ST",
            "address_2": "SUITE 320",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031243",
            "telephone_number": "716-816-7200",
            "fax_number": "716-852-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "address_2": "6TH FL",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-882-6544",
            "fax_number": "716-882-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIERBRAUER",
        "first_name": "MARY",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "415468-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1578852786",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6516597",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03338869",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.