Individual provider Active NPI

Betsy L Strack, P.A.

  • Physician Assistant
  • Derby, NY
National Provider Identifier
1750464160
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6763 Erie Rd
Derby, NY 14047-9670
Phone
(716) 947-2222
Fax
(716) 947-2223
NPI assigned
Oct 23, 2006
Last updated
Sep 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

6763 Erie Rd
Derby, NY 14047-9670

Mailing address

6763 Erie Rd
Derby, NY 14047-9670
Phone (716) 947-2222

Other identifiers 1

IdentifierTypeStateIssuer
02865832MedicaidNY

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
I20070706000367 NY Practitioner - Physician Assistant 7719087626 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011637NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Aug 28, 2023 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Aug 28, 2023 Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Current Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
John Mulawka DO PC Past Accepting new patients
General Physician, PC PastSince Apr 1, 2016 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients
John Mulawka DO, PC Past Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1750464160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6763 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-947-2222",
            "fax_number": "716-947-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6763 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-947-2222",
            "fax_number": "716-947-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRACK",
        "first_name": "BETSY",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02865832",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

Verify at the official NPI Registry.