Individual provider Active NPI

Stephanie Michelle Roberts, FNP

  • Family Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1760146450
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F349723 Issued in NY
Practice address
5959 Big Tree Rd Ste 102
Orchard Park, NY 14127-2291
Phone
(716) 422-5677
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F349723 NY Primary

Addresses

Primary practice location

5959 Big Tree Rd Ste 102
Orchard Park, NY 14127-2291

Mailing address

4481 Clinton St
West Seneca, NY 14224-1700
Phone (716) 517-6391

Other names 1

  • Stephanie M Roberts Other name

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
I20221114001314 NY Practitioner - Nurse Practitioner 4981071453 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F349723NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Nov 7, 2022 Accepting new patients

Locations

1031 Michigan Ave
Buffalo, NY 14203
Phone (716) 686-8460

1014 Delaware Ave
Buffalo, NY 14209
Phone (716) 361-8616

3980A Sheridan Dr
Ste 200
Buffalo, NY 14226
Phone (716) 309-4772

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

5775 Maelou Dr
Hamburg, NY 14075
Phone (716) 648-2820

104 Old Niagara Rd
Lockport, NY 14094
Phone (716) 434-6093

5959 Big Tree Rd
Ste 102
Orchard Park, NY 14127
Phone (716) 422-5677

Interoperability endpoints

  • Direct secure messaging: slatoszek@gppc.medentdirect.com

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": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1760146450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4481 CLINTON ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241700",
            "telephone_number": "716-517-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 BIG TREE RD STE 102",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272291",
            "telephone_number": "716-422-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ROBERTS",
            "middle_name": "M",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.