Individual provider Active NPI

Andrea Elizabeth Phipps, PA

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1881027845
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016680 Issued in NY
Practice address
60 Maple Rd
Suite 1
Williamsville, NY 14221-2917
Phone
(716) 626-5250
Fax
(716) 332-2218
NPI assigned
Aug 14, 2013
Last updated
Aug 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016680 NY Primary

Addresses

Primary practice location

60 Maple Rd
Suite 1
Williamsville, NY 14221-2917

Mailing address

60 Maple Rd
Suite 1
Williamsville, NY 14221-2917
Phone (716) 626-5250

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
I20131202000332 NY Practitioner - Physician Assistant 8628204351 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Sep 30, 2019 Accepting new patients
Gastrointestinal Group Past Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1881027845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "ANDREA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.