Individual provider Active NPI

Brittany Ann Wahl, FNP

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1639067663
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357147 Issued in NY
Practice address
1021 Broadway St FL 3
Buffalo, NY 14212-1460
Phone
(716) 881-6191
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357147 NY Primary

Addresses

Primary practice location

1021 Broadway St FL 3
Buffalo, NY 14212-1460

Mailing address

1021 Broadway St
Buffalo, NY 14212-1460
Phone (716) 529-3020

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
I20250903002278 NY Practitioner - Nurse Practitioner 1557863255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jericho Road Ministries, Inc.Group PAC ID 5597992933, 33 clinicians

Practice addresses (Care Compare)

1021 Broadway St
Buffalo, NY 14212-1460
Phone (716) 529-3020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
357147NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jericho Road Ministries Inc. CurrentSince Aug 1, 2025 Accepting new patients
Jericho Road Ministries, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

184 Barton St
Buffalo, NY 14213
Phone (716) 348-3000

1500 Main St
Buffalo, NY 14209
Phone (716) 503-9777

100 E Tupper St
Buffalo, NY 14203
Phone (716) 539-6743

182 Breckenridge St
Buffalo, NY 14213
Phone (716) 348-3011

21 Doat St
Buffalo, NY 14211
Phone (716) 339-9210

1021 Broadway St
Fl 3
Buffalo, NY 14212
Phone (716) 529-3020

1021 Broadway St
Bldg 3RD
Buffalo, NY 14212

1021 Broadway St
Buffalo, NY 14212
Phone (716) 529-3020

Interoperability endpoints

  • Direct secure messaging: brittany.wahl@jrchc.medentdirect.com

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1639067663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121460",
            "telephone_number": "716-529-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BROADWAY ST FL 3",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121460",
            "telephone_number": "716-881-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "BRITTANY",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.