Active NPI
Brooke Radecki
- Physician Assistant
- Buffalo, NY
National Provider Identifier
1902734668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 035937
- Practice address
- 2157 Main St
Buffalo, NY 14214-2648 - Phone
- (716) 862-1000
- Fax
- (716) 352-1639
- NPI assigned
- May 12, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 035937 | NY | Primary |
Addresses
Primary practice location
2157 Main St
Buffalo, NY 14214-2648
Mailing address
27 Red Clover LN
Lancaster, NY 14086-4407
Phone (716) 352-1639
Other practice location 1
2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone (716) 891-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787270400000",
"number": "1902734668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 RED CLOVER LN",
"city": "LANCASTER",
"state": "NY",
"postal_code": "140864407",
"telephone_number": "716-352-1639",
"fax_number": "716-352-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142648",
"telephone_number": "716-862-1000",
"fax_number": "716-352-1639"
}
],
"practiceLocations": [
{
"address_1": "2605 Harlem Rd",
"address_purpose": "LOCATION",
"city": "Cheektowaga",
"state": "NY",
"postal_code": "142254018",
"country_code": "US",
"telephone_number": "716-891-2400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RADECKI",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-12",
"last_updated": "2026-08-21",
"certification_date": "2026-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "035937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.