Individual provider Active NPI

Nicole Wanser, NP

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1780089581
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339190 Issued in NY
Practice address
61 Maple Rd
Williamsville, NY 14221-2918
Phone
(716) 565-1234
Fax
(716) 565-1246
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 339190 NY Primary

Addresses

Primary practice location

61 Maple Rd
Williamsville, NY 14221-2918

Mailing address

61 Maple Rd
Williamsville, NY 14221-2918
Phone (716) 565-1234

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
I20141230001249 NY Practitioner - Nurse Practitioner 4284957101 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
Telehealth
Offers telehealth services
Group practices
Family Care Physician, P.C.Group PAC ID 0042249328, 12 clinicians

Practice addresses (Care Compare)

61 Maple Rd
Williamsville, NY 14221-2918
Phone (716) 565-1234

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339190NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Physician, P.C. Family CurrentSince Jul 8, 2024 Accepting new patients
Northtowns Imaging PC PastSince Jun 16, 2024 Accepting new patients

Locations

61 Maple Rd
Williamsville, NY 14221
Phone (716) 565-1234

Interoperability endpoints

  • Direct secure messaging: nwanser@familycarephysicians.medentdirect.com

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.

Hospital & facility affiliations 8

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1780089581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234",
            "fax_number": "716-565-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234",
            "fax_number": "716-565-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANSER",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.