Individual provider Active NPI

Jill C. Stein, NP

  • Adult Health Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1689262230
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309972 Issued in NY
Practice address
495 International Dr.
Williamsville, NY 14221-5725
Phone
(716) 810-9292
Fax
(716) 810-9289
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309972 NY Primary

Addresses

Primary practice location

495 International Dr.
Williamsville, NY 14221-5725

Mailing address

495 International Dr.
Williamsville, NY 14221-5725
Phone (716) 810-9292

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
I20210311002263 NY Practitioner - Nurse Practitioner 2769898089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Kenmore Family Medicine LLPGroup PAC ID 6901895036, 5 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F309972NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kenmore Family Medicine, LLP CurrentSince Apr 18, 2022 Accepting new patients
Chadha Medicals PC CurrentSince Mar 1, 2021 Accepting new patients

Locations

2914 Elmwood Ave
Kenmore, NY 14217
Phone (716) 447-6310

495 International Dr
Williamsville, NY 14221
Phone (716) 565-3999

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.

Hospital & facility affiliations 3

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": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1689262230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 INTERNATIONAL DR.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215725",
            "telephone_number": "716-810-9292",
            "fax_number": "716-810-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 INTERNATIONAL DR.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215725",
            "telephone_number": "716-810-9292",
            "fax_number": "716-810-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "JILL",
        "middle_name": "C.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.