Individual provider Active NPI

Elizabeth Certo, P.A.

  • Physician Assistant
  • Kenmore, NY
National Provider Identifier
1639113129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008977-1 Issued in NY
Practice address
2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone
(716) 875-6700
Fax
(716) 875-6853
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 008977-1 NY Primary

Addresses

Primary practice location

2914 Elmwood Ave
Kenmore, NY 14217-1332

Mailing address

2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone (716) 875-6700

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
I20040512001051 NY Practitioner - Physician Assistant 6709876816 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 884-3000

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 568-3600

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008977-1NYMDPhysician Assistant

Organizations & group practices 4

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 6

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639113129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-875-6700",
            "fax_number": "716-875-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-875-6700",
            "fax_number": "716-875-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERTO",
        "first_name": "ELIZABETH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008977-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

Verify at the official NPI Registry.