Individual provider Active NPI

Jennifer Gilmore, D.C.

  • Chiropractor
  • Buffalo, NY
National Provider Identifier
1710422977
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012901-1 Issued in NY
Practice address
2625 Delaware Ave
Buffalo, NY 14216-1705
Phone
(716) 335-9711
Fax
(716) 335-9696
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012901-1 NY Primary

Addresses

Primary practice location

2625 Delaware Ave
Buffalo, NY 14216-1705

Mailing address

2625 Delaware Ave
Buffalo, NY 14216-1705
Phone (716) 335-9711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170210000615 NY Practitioner - Chiropractic 3274816517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marciniak Chiropractic PLLCGroup PAC ID 1850515388, 7 clinicians

Practice addresses (Care Compare)

989 Kenmore Ave
Kenmore, NY 14217-2924
Phone (716) 335-9711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012901-1NYMDChiropractor
012901NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marciniak Chiropractic PLLC Chiropractor CurrentSince Jan 1, 2017 Accepting new patients

Locations

989 Kenmore Ave
Kenmore, NY 14217
Phone (716) 335-9711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1710422977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161705",
            "telephone_number": "716-335-9711",
            "fax_number": "716-335-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161705",
            "telephone_number": "716-335-9711",
            "fax_number": "716-335-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "JENNIFER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012901-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.