Individual provider Active NPI

Renee M Crooks, PA

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1851771778
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006134-01 Issued in NY
Practice address
61 Maple Rd
Williamsville, NY 14221-2918
Phone
(716) 565-1234
Fax
(716) 565-1246
NPI assigned
Jun 5, 2015
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002582L PA
Physician Assistant 363A00000X 006134-01 NY Primary

Addresses

Primary practice location

61 Maple Rd
Williamsville, NY 14221-2918

Mailing address

61 Maple Rd
Williamsville, NY 14221-2918
Phone (716) 565-1234

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
I20210921001596 NY Practitioner - Physician Assistant 6800109810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Physician, P.C.Group PAC ID 0042249328, 12 clinicians

Practice addresses (Care Compare)

61 Maple Rd
Williamsville, NY 14221-2918
Phone (716) 565-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006134-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Health Corporation Past Accepting new patients
Northtowns Imaging PC PastSince Aug 8, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rcrooks@familycarephysicians.medentdirect.com

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 2

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": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1851771778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234",
            "fax_number": "716-565-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234",
            "fax_number": "716-565-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002582L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006134-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.