Individual provider Active NPI

Jennifer Pangelinan, RN

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1831571223
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311198-01 Issued in NY
Practice address
3495 Bailey Ave
Buffalo, NY 14215-1129
Phone
(925) 566-4666
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 699465 NY
Adult Health Nurse Practitioner 363LA2200X F311198-01 NY Primary

Addresses

Primary practice location

3495 Bailey Ave
Buffalo, NY 14215-1129

Mailing address

184 Deerhurst Park Blvd
Buffalo, NY 14217-2106
Phone (925) 566-4666

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
I20240116002209 NY Practitioner - Nurse Practitioner 0749632701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 884-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
699465NYMDRegistered Nurse
311198NYMDLicensed Practical Nurse
F311198-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

100 High St
#D1
Buffalo, NY 14203
Phone (716) 422-0010

3495 Bailey Ave
Buffalo, NY 14215
Phone (716) 862-8881

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

5844 Southwestern Blvd
Ste 500
Hamburg, NY 14075
Phone (716) 626-4200

Interoperability endpoints

  • Direct secure messaging: jpangelinan@gppc.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1831571223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 DEERHURST PARK BLVD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142172106",
            "telephone_number": "925-566-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "925-566-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGELINAN",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "699465",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311198-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.