Individual provider Active NPI

Danielle Killian

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1629626098
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023724 Issued in NY
Practice address
Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone
(716) 845-2300
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023724 NY Primary

Addresses

Primary practice location

Elm and Carlton Streets
Buffalo, NY 14263-0001

Mailing address

Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other identifiers 1

IdentifierTypeStateIssuer
023724OtherNYNYS LICENSE

Other names 1

  • Danielle Wegrzyn 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
I20191004001226 NY Practitioner - Physician Assistant 0547591620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Sep 12, 2019 Accepting new patients
Roswell Park Cancer Institute CurrentSince Sep 12, 2019 Accepting new patients

Locations

Elm and Carlton St
Buffalo, NY 14263

Dept 8000
Buffalo, NY 14267

Organizations & group practices 2

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": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1629626098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "023724",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "WEGRZYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.