Individual provider Active NPI

Amandajoe Sullivan Nowadly

  • Speech-Language Pathologist
  • Buffalo, NY
National Provider Identifier
1942672787
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
025165 Issued in NY
Practice address
50 E North St
Buffalo, NY 14203-1002
Phone
(716) 885-8318
NPI assigned
Oct 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 025165 NY Primary

Addresses

Primary practice location

50 E North St
Buffalo, NY 14203-1002

Mailing address

467 W Delavan Ave
Upper
Buffalo, NY 14213-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160107000243 NY Practitioner - Qualified Speech Language Pathologist 0244532380 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025165NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Hearing & Speech Center, Inc Speech-Language Pathologist CurrentSince Feb 26, 2024 Accepting new patients

Locations

50 E North St
Buffalo, NY 14203
Phone (716) 885-8318

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": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1942672787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 W DELAVAN AVE",
            "address_2": "UPPER",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E NORTH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031002",
            "telephone_number": "716-885-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWADLY",
        "first_name": "AMANDAJOE",
        "middle_name": "SULLIVAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025165",
            "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 Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.