Individual provider Active NPI

Amy Lynn Donnelly

  • Gerontology Nurse Practitioner
  • West Seneca, NY
National Provider Identifier
1811626260
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F310111-01 Issued in NY
Practice address
725 Orchard Park Rd
Ste a
West Seneca, NY 14224
Phone
(716) 675-1001
NPI assigned
Jun 9, 2022
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F310111-01 NY Primary

Addresses

Primary practice location

725 Orchard Park Rd
Ste a
West Seneca, NY 14224

Mailing address

725 Orchard Park Rd Ste a
Buffalo, NY 14224-3352
Phone (716) 675-1001

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
I20230103001549 NY Practitioner - Nurse Practitioner 5092185314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

290 Ctr Rd
West Seneca, NY 14224-1945

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F310111-01NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lall Medical, LLC CurrentSince Nov 21, 2022 Accepting new patients
Lall Orthopedics LLC PastSince Jun 12, 2022 Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1811626260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 ORCHARD PARK RD STE A",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142243352",
            "telephone_number": "716-675-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ORCHARD PARK RD",
            "address_2": "STE A",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224",
            "telephone_number": "716-675-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F310111-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.