Individual provider Active NPI

Edna Angelina, NP

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1972561801
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334670 Issued in NY
Practice address
50 Lakefront Blvd
Suite 130
Buffalo, NY 14202-4345
Phone
(716) 849-8750
Fax
(716) 849-8757
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F334670 NY Primary

Addresses

Primary practice location

50 Lakefront Blvd
Suite 130
Buffalo, NY 14202-4345

Mailing address

50 Lakefront Blvd
Suite 130
Buffalo, NY 14202-4345
Phone (716) 849-8750

Other identifiers 1

IdentifierTypeStateIssuer
02735486MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F334670NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1972561801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LAKEFRONT BLVD",
            "address_2": "SUITE 130",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024345",
            "telephone_number": "716-849-8750",
            "fax_number": "716-849-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LAKEFRONT BLVD",
            "address_2": "SUITE 130",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024345",
            "telephone_number": "716-849-8750",
            "fax_number": "716-849-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELINA",
        "first_name": "EDNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02735486",
            "state": "NY"
        }
    ],
    "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 Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.