Individual provider Active NPI

Nancy L Sullivan, NP

  • Adult Health Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1992713598
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F303529-1 Issued in NY
Practice address
295 Essjay Rd
Williamsville, NY 14221-8216
Phone
(716) 630-1045
Fax
(716) 630-1451
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303529-1 NY Primary

Addresses

Primary practice location

295 Essjay Rd
Williamsville, NY 14221-8216

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other identifiers 6

IdentifierTypeStateIssuer
000560711001OtherNYHEALTH NOW
02292157MedicaidNY
161000580OtherNYGHI
161000580OtherNYNOVA
00026526201OtherNYUNIVERA
9512257OtherNYIHA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

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
I20100217000018 NY Practitioner - Nurse Practitioner 1456495316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Buffalo School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 630-1000

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 630-1000

85 High St
Buffalo, NY 14203-1149
Phone (716) 630-1000

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • Bertrand Chaffee Hospital Hospital, Springville, NY, CCN 330111

Merit-based Incentive Payment System (MIPS)

Final score
91.31 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
83.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F303529-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Apr 19, 2012 Accepting new patients
Kaleida Health CurrentSince Apr 19, 2012 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2002 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2002 Accepting new patients
Kaleida Health Current Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

6950 S Transit Rd
Lockport, NY 14094
Phone (716) 630-1322

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

6255 Sheridan Dr
Williamsville, NY 14221
Phone (716) 857-8666

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

295 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1050

Interoperability endpoints

  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1992713598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218216",
            "telephone_number": "716-630-1045",
            "fax_number": "716-630-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NANCY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303529-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000560711001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02292157",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026526201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512257",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "295 Essjay Rd",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142218216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.