Individual provider Active NPI

Brianna L Nuttle, PA

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1992206221
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021869 Issued in NY
Practice address
1540 Maple Rd
Williamsville, NY 14221-3647
Phone
(716) 568-3600
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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 021869 NY Primary

Addresses

Primary practice location

1540 Maple Rd
Williamsville, NY 14221-3647

Mailing address

275 Northpointe Pkwy Ste 50
Amherst, NY 14228-1895
Phone (716) 389-3294

Other practice location 1

529 Central Ave
Dunkirk, NY 14048-2514
Phone (716) 366-1111

Other practice location 2

445 Tremont St
North Tonawanda, NY 14120-6150
Phone (716) 694-4500

Other names 1

  • Brianna Fiocco Former name

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
I20180410003207 NY Practitioner - Physician Assistant 8123381803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
76.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021869NYMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Organizations & group practices 2

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1992206221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 NORTHPOINTE PKWY STE 50",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142281895",
            "telephone_number": "716-389-3294",
            "fax_number": "716-639-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213647",
            "telephone_number": "716-568-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "529 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "NY",
            "postal_code": "140482514",
            "country_code": "US",
            "telephone_number": "716-366-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 Tremont St",
            "address_purpose": "LOCATION",
            "city": "North Tonawanda",
            "state": "NY",
            "postal_code": "141206150",
            "country_code": "US",
            "telephone_number": "716-694-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTTLE",
        "first_name": "BRIANNA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "FIOCCO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.