Individual provider Active NPI

Heather Fenley Crabtree, MD

  • Otolaryngology Physician
  • Orchard Park, NY
National Provider Identifier
1790195675
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
318450-01 Issued in NY
Practice address
3670 S Benzing Rd Ste C
Orchard Park, NY 14127-1741
Phone
(215) 300-2577
NPI assigned
May 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 73244 WI
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 318450-01 NY Primary

Addresses

Primary practice location

3670 S Benzing Rd Ste C
Orchard Park, NY 14127-1741

Mailing address

3670 S Benzing Rd Ste C
Orchard Park, NY 14127-1741
Phone (215) 300-2577

Other practice location 1

6255 Sheridan Dr Ste 108
Williamsville, NY 14221-4825
Phone (716) 675-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201002001172 WI Practitioner - Otolaryngology 9638598147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
318450-01NYMDOtolaryngology Physician
73244WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Sep 1, 2020 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

13133 N Port Washington Rd
Ste 226
Mequon, WI 53097
Phone (262) 243-3660

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1790195675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271741",
            "telephone_number": "215-300-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271741",
            "telephone_number": "215-300-2577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6255 Sheridan Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142214825",
            "country_code": "US",
            "telephone_number": "716-675-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRABTREE",
        "first_name": "HEATHER",
        "middle_name": "FENLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "73244",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "318450-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.