Individual provider Active NPI

Justine E Kurtzner, NP

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1639432743
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337351 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone
(716) 845-2300
Fax
(716) 845-3423
NPI assigned
Jun 22, 2012
Last updated
Mar 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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 F337351 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-0001

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
03507453MedicaidNY

Other names 1

  • Justine E Bertolo 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
I20130225000260 NY Practitioner - Nurse Practitioner 8921253972 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F337351NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Mar 12, 2019 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Mar 12, 2019 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jun 15, 2012 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jun 15, 2012 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: jkurtzner83824@direct.upstate.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1639432743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZNER",
        "first_name": "JUSTINE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03507453",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "BERTOLO",
            "middle_name": "E",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.