Individual provider Active NPI

Andrea Marie Overturf, NP

  • Pediatric Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1811209695
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382141 Issued in NY
Practice address
1800 Maple Road
Suite 100
Williamsville, NY 14221-2749
Phone
(716) 636-5437
Fax
(716) 276-3190
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382141 NY Primary
Pediatric Nurse Practitioner 363LP0200X ARNP9278522 FL
Pediatric Nurse Practitioner 363LP0200X 16129 CT
Nurse Practitioner 363L00000X APRN9278522 FL
Pediatric Critical Care Medicine Physician 2080P0203X APRN9278522 FL

Addresses

Primary practice location

1800 Maple Road
Suite 100
Williamsville, NY 14221-2749

Mailing address

101 St. Clare Terrace
Tonawanda, NY 14150
Phone (716) 316-0722

Other practice location 1

3055 Southwestern Blvd
Orchard Park, NY 14127-1231
Phone (716) 636-5437

Other practice location 2

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

Other identifiers 2

IdentifierTypeStateIssuer
03285307MedicaidNY
023348100MedicaidFL

Other names 1

  • Andrea Marie Reynolds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121016000173 FL Practitioner - Nurse Practitioner 4789834441 Reassigns benefits to 2 organizations
I20260408000327 CT Practitioner - Nurse Practitioner 4789834441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Columbus Blvd
Hartford, CT 06106-1973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16129CTMDClinical Social Worker
APRN9278522FLMDPediatric Critical Care Medicine Physician
ARNP9278522FLMDPediatric Nurse Practitioner
382141NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 6, 2015 Accepting new patients
The Nemours Foundation CurrentSince Dec 25, 2017 Accepting new patients
The Nemours Foundation CurrentSince Dec 25, 2017 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Jul 6, 2015 Accepting new patients
Pediatric and Adolescent Urgent Care of the Southtowns, PLLC Past Accepting new patients
Pediatric and Adolescent Urgent Care of Western New York PastSince Nov 5, 2023 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

900 Winderley Pl
Ste 1400
Maitland, FL 32751
Phone (407) 200-2700

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

2501 N Orange Ave
Ste 310
Orlando, FL 32804
Phone (407) 856-7226

Interoperability endpoints

  • Direct secure messaging: areynolds@pedsurgentcare.medentdirect.com
  • Direct secure messaging: areynolds68581@direct.nemours.org

Organizations & group practices 8

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1811209695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ST. CLARE TERRACE",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "14150",
            "telephone_number": "716-316-0722",
            "fax_number": "716-276-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MAPLE ROAD",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212749",
            "telephone_number": "716-636-5437",
            "fax_number": "716-276-3190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Southwestern Blvd",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271231",
            "country_code": "US",
            "telephone_number": "716-636-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVERTURF",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382141",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9278522",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "16129",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9278522",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "APRN9278522",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03285307",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023348100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "REYNOLDS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.