MS. JENNY T. BAGEN (NPI# 1184647505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184647505 |
| Entity Type | Individual |
| Full Name | MS. JENNY T. BAGEN |
| Credential | NP |
| Practice Address |
1405 Sheridan Dr Tonawanda NY 14217-1248 |
| Practice Telephone | 7164322892 |
| Practice Fax Number | 7163894155 |
| Mailing Telephone | 7164322892 |
| Mailing Fax Number | 7163894155 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-02-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F400997 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F400997-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02792363 | 05 |
| Street Address |
1405 SHERIDAN DR |
| City | TONAWANDA |
| State | NY |
| Zip Code | 14217-1248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588669741 | Bonny Lou Owens | Specialist | 1405 Sheridan Dr, Tonawanda, NY 14217-1248 | 2005-06-15 |
| 1710090154 | Michael Sanford Bernstein | Podiatrist | 1405 Sheridan Dr, Tonawanda, NY 14217 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585201 | Emma Rae Rooney | Student in an Organized Health Care Education/Training Program | 2900 Delaware Ave., Kenmore, NY 14217 | 2019-12-11 |
| 1558801530 | Elizabeth Fazio | Local Education Agency (LEA) | 3767 Delaware Ava, Kenmore, NY 14217 | 2017-02-24 |
| 1477940393 | Laura Sabia | Case Manager/Care Coordinator | 2900 Deleware Avenue, Kenmore, NY 14217 | 2015-04-17 |
| 1770994881 | Kenmore Family Medicine | Family Medicine | 2914 Elmwood Avenue, Kenmore, NY 14217 | 2014-05-12 |
| 1144576265 | Elizabeth Anne Leiser | Nurse Practitioner | 274 W Girard Blvd, Kenmore, NY 14217 | 2012-07-26 |
| 1730442385 | Christopher Landeo | Case Manager/Care Coordinator | 2900 Delaware Avenue, Kenmore, NY 14217 | 2012-06-19 |
| 1013291095 | Sharon Karnyski | Physical Therapist | 2900 Delaware Avenu, Kenmore, NY 14217 | 2011-10-07 |
| 1164706784 | Joanne Karen Cascio | Registered Nurse | 3756 Delaware Avenue, Kenmore, NY 14217 | 2011-09-30 |
| 1467742692 | Nicole Anne Perrotta | Occupational Therapy Assistant | 3767 Delaware Avenue, Kenmore, NY 14217 | 2011-04-08 |
| 1538466511 | Diane J. Sutter, M.d., LLC | Obstetrics & Gynecology | 3800 Delaware Avenue, Suite 102, Kenmore, NY 14217 | 2011-02-28 |
| Find all providers in zip 14217 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831526763 | Terry Jo Brooks-devlin | Nurse Practitioner | 612 Adam St, Tonawanda, NY 14150-3626 | 2013-10-10 |
| 1659936748 | Danielle Simmons | Nurse Practitioner | 1370 Niagara Falls Blvd, Tonawanda, NY 14150-8441 | 2019-05-05 |
| 1396251690 | Ashley Anne Ciresi | Nurse Practitioner | 1370 Niagara Falls Blvd, Tonawanda, NY 14150-8441 | 2017-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518794 | Johnson Oppong | Nurse Practitioner | 160 Theodore Fremd Ave Apt C2, Rye, NY 10580-2842 | 2020-11-08 |
| 1619578366 | Jecinter L Otieno | Nurse Practitioner | 195 Hillside Dr, Oneonta, NY 13820-3611 | 2020-11-07 |
| 1073113833 | Natalie Grant-villegas | Nurse Practitioner | 1210 Fulton St Apt 1, Brooklyn, NY 11216-2003 | 2020-10-29 |
| 1780284869 | Mary Gwynne Tillotson | Nurse Practitioner | 82 Oxford Ave, Buffalo, NY 14209-1406 | 2020-10-28 |
| 1780284273 | Angela Abramov | Nurse Practitioner | 141-30 Pershing Creacsent Apt 3c, Jamaica, NY 11435 | 2020-10-26 |
| 1407455967 | Marie J. Schwarz, Npp-bc PC | Nurse Practitioner | 133 E Main St Ste 3h, Babylon, NY 11702-3517 | 2020-10-25 |
| 1720687015 | Ashley Winn | Nurse Practitioner | 367 E Chester St, Long Beach, NY 11561-2324 | 2020-10-19 |
| 1114525961 | Tanya Monique Sydnor Holmes | Nurse Practitioner | 1601 Baldwin Blvd, Bay Shore, NY 11706-2145 | 2020-10-14 |
| 1669079976 | Mary Lynn Good | Nurse Practitioner | 3344 Chambers Rd # 200, Horseheads, NY 14845-1403 | 2020-10-08 |
| 1376140277 | Megan Elizabeth Bhatti | Nurse Practitioner | 2104 Delaware Ave Apt 1, Buffalo, NY 14216-3216 | 2020-10-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.