Individual provider Active NPI

Elicia Quagliariello, CRNA

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1740520451
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
600125 Issued in NY
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 836-7510
Fax
(716) 832-3540
NPI assigned
Feb 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 600125 NY Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

3871 Harlem Rd Ste 202
Buffalo, NY 14215-1946
Phone (716) 836-7510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130722000329 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709027568 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
600125NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2015 Accepting new patients
Northtowns Ambulatory Surgery Center, LLC CurrentSince Sep 21, 2024 Accepting new patients

Locations

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

111 N Maplemere Rd
Williamsville, NY 14221
Phone (716) 713-4310

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.

NPI Registry JSON

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1740520451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 HARLEM RD STE 202",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151946",
            "telephone_number": "716-836-7510",
            "fax_number": "716-832-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-836-7510",
            "fax_number": "716-832-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAGLIARIELLO",
        "first_name": "ELICIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "600125",
            "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 Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.