Individual provider Active NPI

Mandi Ranee Kuppel, NP

  • Family Nurse Practitioner
  • Dunkirk, NY
National Provider Identifier
1780309039
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350512 Issued in NY
Practice address
75 E 3Rd St
Dunkirk, NY 14048-2239
Phone
(716) 366-6036
Fax
(833) 974-1992
NPI assigned
Oct 10, 2022
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 350512 NY Primary

Addresses

Primary practice location

75 E 3Rd St
Dunkirk, NY 14048-2239

Mailing address

75 E 3Rd St
Dunkirk, NY 14048-2239
Phone (716) 363-6050

Other practice location 1

10988 Bennett-State Road
Forestville, NY 14062
Phone (716) 363-6050

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
I20230821000222 NY Practitioner - Nurse Practitioner 1951763101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Chautauqua Center IncGroup PAC ID 7214178326, 35 clinicians

Practice addresses (Care Compare)

75 E 3Rd St
Dunkirk, NY 14048-2239
Phone (716) 363-6050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Chautauqua Center, Inc CurrentSince Jul 5, 2023 Accepting new patients
Chautauqua PT OT & SLP Professionals PLLC Past Accepting new patients

Locations

1134 Central Ave
Dunkirk, NY 14048
Phone (716) 366-6036

10988 Bennett State Rd
Forestville, NY 14062
Phone (716) 732-7770

Interoperability endpoints

  • Direct secure messaging: mandi.kuppel.1@22211.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1780309039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482239",
            "telephone_number": "716-363-6050",
            "fax_number": "833-974-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482239",
            "telephone_number": "716-366-6036",
            "fax_number": "833-974-1992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10988 Bennett-State Road",
            "address_purpose": "LOCATION",
            "city": "Forestville",
            "state": "NY",
            "postal_code": "14062",
            "country_code": "US",
            "telephone_number": "716-363-6050",
            "fax_number": "833-471-6206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPPEL",
        "first_name": "MANDI",
        "middle_name": "RANEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

Verify at the official NPI Registry.