Individual provider Active NPI

Jessica M Kostrewa, NP

  • Nurse Practitioner
  • Lockport, NY
National Provider Identifier
1588066468
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F306893 Issued in NY
Practice address
6000 Brockton Dr
Lockport, NY 14094-9273
Phone
(716) 845-3400
Fax
(716) 438-1430
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306893 NY
Nurse Practitioner 363L00000X F306893 NY Primary

Addresses

Primary practice location

6000 Brockton Dr
Lockport, NY 14094-9273

Mailing address

199 Park Club LN Ste 500
Williamsville, NY 14221-5269
Phone (716) 845-1300

Other practice location 1

7500 Porter Rd
Niagara Falls, NY 14304-1604
Phone (716) 298-1273

Other identifiers 1

IdentifierTypeStateIssuer
04039149MedicaidNY

Other names 1

  • Jessica M Vail Former name

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
I20150225000678 NY Practitioner - Nurse Practitioner 8921324609 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

6000 Brockton Dr
Lockport, NY 14094-9273
Phone (716) 845-3400

Hospital & facility affiliations

  • Roswell Park Cancer Institute Hospital, Buffalo, NY, CCN 330354

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F306893NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Emergency Medical Services Inc. Current Accepting new patients
Saif Soniwala,M.D.,PC Current Accepting new patients
Ub Family Medicine, Inc CurrentSince Oct 1, 2014 Accepting new patients
Trinity Medical Wny PC Adult Health CurrentSince Jan 1, 2018 Accepting new patients
Rpci Oncology PC CurrentSince Sep 8, 2025 Accepting new patients
Trinity Medical Wny PC CurrentSince Jan 1, 2018 Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3719 Union Rd
Ste 218
Cheektowaga, NY 14225
Phone (716) 206-1503

6000 Brockton Dr
Lockport, NY 14094
Phone (716) 439-0345

7500 Porter Rd
Niagara Falls, NY 14304
Phone (716) 298-1273

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

199 Park Club Ln
Ste 100
Williamsville, NY 14221
Phone (716) 332-6834

199 Park Club Ln
Ste 500
Williamsville, NY 14221

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1588066468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 PARK CLUB LN STE 500",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215269",
            "telephone_number": "716-845-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BROCKTON DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949273",
            "telephone_number": "716-845-3400",
            "fax_number": "716-438-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Porter Rd",
            "address_purpose": "LOCATION",
            "city": "Niagara Falls",
            "state": "NY",
            "postal_code": "143041604",
            "country_code": "US",
            "telephone_number": "716-298-1273",
            "fax_number": "716-298-1285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTREWA",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306893",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F306893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04039149",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VAIL",
            "middle_name": "M",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.