Individual provider Active NPI

Emily Anne Mogavero, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1902792021
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034569 Issued in NY
Practice address
800 Hertel Ave Ste 100
Buffalo, NY 14207-1906
Phone
(716) 847-2441
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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 034569 NY Primary

Addresses

Primary practice location

800 Hertel Ave Ste 100
Buffalo, NY 14207-1906

Mailing address

206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone (716) 847-2441

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
I20251202002862 NY Practitioner - Physician Assistant 2062905623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehs, IncGroup PAC ID 7618946310, 41 clinicians

Practice addresses (Care Compare)

800 Hertel Ave
Buffalo, NY 14207-1906
Phone (716) 847-2441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034569NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehs, Inc. CurrentSince Sep 22, 2025 Accepting new patients

Locations

800 Hertel Ave
Ste 100
Buffalo, NY 14207
Phone (716) 847-2441

800 Hertel Ave
Buffalo, NY 14207
Phone (716) 566-5007

206 S Elmwood Ave
Buffalo, NY 14201
Phone (716) 847-0212

Interoperability endpoints

  • Direct secure messaging: emogavero@evergreenhs.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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1902792021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012398",
            "telephone_number": "716-847-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HERTEL AVE STE 100",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071906",
            "telephone_number": "716-847-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGAVERO",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.