Individual provider Active NPI

Dumadi Fernandez, NP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1780219774
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309572-01 Issued in NY
Practice address
1515 Kensington Ave # 104
Buffalo, NY 14215-1436
Phone
(716) 333-8761
NPI assigned
Mar 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 F309572-01 NY Primary

Addresses

Primary practice location

1515 Kensington Ave # 104
Buffalo, NY 14215-1436

Mailing address

1515 Kensington Ave # 104
Buffalo, NY 14215-1436
Phone (716) 333-8761

Other practice location 1

1515 Kensington Ave # 104
Buffalo, NY 14215-1436
Phone (716) 333-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F309572-01NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1780219774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 KENSINGTON AVE # 104",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151436",
            "telephone_number": "716-333-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 KENSINGTON AVE # 104",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151436",
            "telephone_number": "716-333-8761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Kensington Ave # 104",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142151436",
            "country_code": "US",
            "telephone_number": "716-333-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DUMADI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309572-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.