Individual provider Active NPI

Beth Allan Edwards, P.A.

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1790026326
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016448 Issued in NY
Practice address
6 Fountain PLZ
Buffalo, NY 14202-2211
Phone
(716) 308-2557
NPI assigned
Mar 6, 2013
Last updated
Dec 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016448 NY Primary

Addresses

Primary practice location

6 Fountain PLZ
Buffalo, NY 14202-2211

Mailing address

6 Fountain Plaza
Buffalo, NY 14202
Phone (716) 308-2557

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
I20130905000658 NY Practitioner - Physician Assistant 8426291782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delphi Healthcare PLLCGroup PAC ID 9537229661, 68 clinicians

Practice addresses (Care Compare)

621 10TH St
Niagara Falls, NY 14301-1813
Phone (716) 278-4395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group LLC Current Accepting new patients
FDR Medical Services P.C. Past Accepting new patients

Locations

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1790026326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FOUNTAIN PLAZA",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14202",
            "telephone_number": "716-308-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FOUNTAIN PLZ",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142022211",
            "telephone_number": "716-308-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BETH",
        "middle_name": "ALLAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.