Mary T Phelan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F332356-1 Issued in NY

Practice address

85 High St
Buffalo, NY 14203

Phone

(716) 630-1000

Fax

(716) 859-4035

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1639209596
  Medicare reassignment NPD
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1427007046
  NPD
• Kaleida Health

  • Community/Retail Pharmacy
  • Buffalo, NY
  • NPI 1992540546
  NPD
• University at Buffalo Pathologists, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Buffalo, NY
  • NPI 1235155581
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1790793321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215782",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14203",
            "telephone_number": "716-630-1000",
            "fax_number": "716-859-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332356-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00027329201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512998",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000560974001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02699521",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dang Tuan Pham, MD
• Michael Pham, PA-C
• Thu-Minh Diane Pham, MD
• Jennifer Ann Phelan, FNP
• Mary Phelan
• Matthew Phifer
• Pramod Philip
• Sydney Philippe
• Gregory P Phillies, MD
• Debra Phillips Sr.

• Family Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.