Individual provider Active NPI

Jessica Leigh Eldred, FNP

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1992937080
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33-336018 Issued in NY
Practice address
1676 Sunset Ave
4TH Floor
Utica, NY 13502-5416
Phone
(315) 624-8100
NPI assigned
Aug 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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 33-336018 NY Primary

Addresses

Primary practice location

1676 Sunset Ave
4TH Floor
Utica, NY 13502-5416

Mailing address

1676 Sunset Ave
4TH Floor
Utica, NY 13502-5416
Phone (315) 624-8100

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
I20131010001978 NY Practitioner - Nurse Practitioner 9830323567 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians
Cogent Medical Care PCGroup PAC ID 7315836780, 152 clinicians

Practice addresses (Care Compare)

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Hospital & facility affiliations

  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33-336018NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC CurrentSince Jun 25, 2022 Accepting new patients
Cogent Medical Care PC CurrentSince Nov 22, 2024 Accepting new patients
Trinity Medical Wny PC Current Accepting new patients
Trinity Medical Wny PC CurrentSince Jun 25, 2022 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Jul 5, 2021 Accepting new patients

Locations

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

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 1

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": "1250899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1992937080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "address_2": "4TH FLOOR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025416",
            "telephone_number": "315-624-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "address_2": "4TH FLOOR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025416",
            "telephone_number": "315-624-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRED",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-22",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33-336018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.