Individual provider Active NPI

Elizabeth D Smith, CPNP, ANP-C

  • Adult Health Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1851475792
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305061 Issued in NY
Practice address
300 Essjay Rd
Williamsville, NY 14221-8208
Phone
(716) 445-2013
Fax
(716) 839-6740
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 415198 NY
Pediatric Nurse Practitioner 363LP0200X F381387 NY
Adult Health Nurse Practitioner 363LA2200X F305061 NY Primary

Addresses

Primary practice location

300 Essjay Rd
Williamsville, NY 14221-8208

Mailing address

300 Essjay Rd
Williamsville, NY 14221-8208
Phone (716) 445-2013

Other identifiers 5

IdentifierTypeStateIssuer
02345462MedicaidNY
061212000042OtherFIDELIS
00027840501OtherUNIVERA
000560590002OtherBC/BS
9512029OtherIHA

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
I20260302001257 NY Order and Referring Only - Nurse Practitioner 2466559257

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
415198NYMDRegistered Nurse
305061NYMDDermatology Physician
F305061NYMDAdult Health Nurse Practitioner
F381387NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc PastSince Jan 1, 1998 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: esmith@landmarkhealth-direct.org
  • Direct secure messaging: lsmith@wnycmc.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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1851475792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218208",
            "telephone_number": "716-445-2013",
            "fax_number": "716-839-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218208",
            "telephone_number": "716-445-2013",
            "fax_number": "716-839-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "D",
        "credential": "CPNP, ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "415198",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381387",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02345462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "061212000042",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00027840501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000560590002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512029",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.