Jill Fennell

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

290206 Issued in NY

Practice address

818 Ellicott St
Buffalo, NY 14203-1021

Phone

(716) 323-0034

Fax

(716) 323-0292

NPI assigned

May 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  Medicare reassignment NPD

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1689084485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0034",
            "fax_number": "716-323-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ELLICOTT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031021",
            "telephone_number": "716-323-0034",
            "fax_number": "716-323-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "290206",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "290206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05953255",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanieka Felton
• Jennifer Anne Fendya, PHD
• Naiman Michael Emmanuel Fenech, M.D.
• Michael Feneziani
• Mahmoud Fenire, MD
• Robert Fenstermaker, MD
• Darren S Ferer
• Anelisa Fergus
• Dianne Ferguson
• Gail H Ferguson, MD

• Hospitalist Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Hospitalist Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.