Holly Marie Anderson, CNP
Individual provider Active NPI Nurse Practitioner · Buffalo, NY
NPI 1730252016 · NPPES record last updated Jan 4, 2021
Key facts
- NPI
- 1730252016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- COA.17819-NP (OH)
- Practice address
- 1001 Main St FL 5
Buffalo, NY 14203-1009 - Phone
- (716) 323-0130
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201216003321 | NY | Practitioner - Nurse Practitioner | 3072925916 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.17819-NP | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University at Buffalo Pediatric Associates Inc | Current |
Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Past | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Past | Accepting new patients | |
| The Nemours Foundation | Past | Accepting new patients |
Locations
1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031
1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361
1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060
Interoperability endpoints
- handerson106682@direct.nemours.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.17819-NP | OH | Yes |
Addresses
Primary practice location
1001 Main St FL 5
Buffalo, NY 14203-1009
Mailing address
1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0130
Other providers in Buffalo, NY
- Charron Anderson
- Deidre M Anderson
- Demetria Mercedes Anderson
- Elizabeth Anderson
- Graham Joshua Anderson
- Jacquelyn Anderson
- Jerica Anderson
- Jocelyn Jennine Anderson
- Kirsten A Anderson
- Kristal Anderson
All providers in Buffalo, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.