Mallory Andrzejak
Individual provider Active NPI Family Nurse Practitioner · Getzville, NY
NPI 1790347672 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1790347672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F345270-01 (NY)
- Practice address
- 55 Dodge Rd
Getzville, NY 14068-1205 - Phone
- (716) 831-2700
- NPI assigned
- Jul 1, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- State University of New York at Buffalo School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Roswell Park Cancer Institute
Practice addresses (Care Compare)
Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300
Hospital & facility affiliations
- Roswell Park Cancer Institute
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200420002618 | NY | Practitioner - Nurse Practitioner | 0345670006 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 672613 | NY | MD | Registered Nurse |
| 345270 | NY | MD | Nurse Practitioner |
| F345270-01 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Health Services Inc | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HEGDAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 345270 | NY | |
| Family Nurse Practitioner | 363LF0000X | F345270-01 | NY | Yes |
| Registered Nurse | 163W00000X | 672613 | NY |
Addresses
Primary practice location
55 Dodge Rd
Getzville, NY 14068-1205
Mailing address
55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700
Other practice location 1
Elm and Carlton St
Buffalo, NY 14263-1426
Phone (716) 845-2300
Other providers in Getzville, NY
- Susanna Jean Addesa
- Christina Adelmann Haun
- All About Motion Physical Therapy, PLLC
- Madison Alleva
- Sabrina Leonarda Andrysiak
- Jami Lynn Aning
- Safiya Jordan Ansari
- Sara Jean Applin
- Amy Armstrong
- Aspire of Western New York Inc
All providers in Getzville, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.