Individual provider Active NPI

Jennifer Maddison, N.P.

  • Neonatal Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1679671424
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
F381250 Issued in NY
Practice address
601 Elmwood Ave
Box Surg
Rochester, NY 14642-8410
Phone
(585) 275-4435
Fax
(585) 276-2370
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X F381250 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Box Surg
Rochester, NY 14642-8410

Mailing address

601 Elmwood Ave
Box Surg
Rochester, NY 14642-8410
Phone (585) 275-4435

Other identifiers 1

IdentifierTypeStateIssuer
03274095MedicaidNY

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
I20110203000017 NY Practitioner - Nurse Practitioner 2961682349 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F381250NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Sep 23, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Sep 23, 2023 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Oct 15, 2024 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Oct 15, 2024 Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients

Locations

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/
  • Direct secure messaging: jmaddison21308@direct.chsbuffalo.org

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1679671424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX SURG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428410",
            "telephone_number": "585-275-4435",
            "fax_number": "585-276-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX SURG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428410",
            "telephone_number": "585-275-4435",
            "fax_number": "585-276-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDISON",
        "first_name": "JENNIFER",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "F381250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03274095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.