Individual provider Active NPI

Ellen Masters

  • Student in an Organized Health Care Education/Training Program
  • Buffalo, NY
National Provider Identifier
1912633637
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1028 Main St
Buffalo, NY 14202-1102
Phone
(716) 859-5454
NPI assigned
Jul 26, 2022
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1028 Main St
Buffalo, NY 14202-1102

Mailing address

1028 Main St
Buffalo, NY 14202-1102

Other practice location 1

224 Alexander St
Rochester, NY 14607-4000
Phone (585) 922-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250131001084 NY Practitioner - Clinical Psychologist 0143759431 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Jan 1, 2025 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Jan 1, 2025 Accepting new patients
Western New York Truecare Medical PC PastSince Oct 1, 2023 Accepting new patients

Locations

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8251/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1912633637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021102",
            "telephone_number": "716-859-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Alexander St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146074000",
            "country_code": "US",
            "telephone_number": "585-922-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.