Individual provider Active NPI

Heather Leary

  • Adult Health Nurse Practitioner
  • West Seneca, NY
National Provider Identifier
1760874390
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307080-1 Issued in NY
Practice address
1026 Union Rd
West Seneca, NY 14224-3445
Phone
(716) 712-0851
Fax
(716) 712-0853
NPI assigned
Feb 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307080-1 NY Primary

Addresses

Primary practice location

1026 Union Rd
West Seneca, NY 14224-3445

Mailing address

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

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
I20150415000504 NY Practitioner - Nurse Practitioner 6204154677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southgate Medical Group LLPGroup PAC ID 7911810189, 31 clinicians

Practice addresses (Care Compare)

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 712-0851

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F307080-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southgate Medical Group,LLP CurrentSince Apr 1, 2015 Accepting new patients

Locations

1026 Union Rd
West Seneca, NY 14224
Phone (716) 712-0851

Interoperability endpoints

  • Direct secure messaging: hlearynp@smg.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1760874390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307080-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.