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MR. DENNIS MICHAEL JACK FNP
NPI 1659858827
Nurse Practitioner - Family in Buffalo, NY

Active since July 20, 2018PECOS EnrolledAccepts Medicare Assignment
90.03/100
CMS Quality Rating
462 GRIDER ST, BUFFALO, NY 14215(716) 609-0312 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 10, 2021, Jul 20, 2018 (2 updates tracked since 2018).

About Mr. Dennis Michael Jack Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DENNIS MICHAEL JACK FNP (NPI 1659858827) is an individual family provider in Buffalo, New York, licensed in New York (343352) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, is affiliated with Kaleida Health, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1659858827
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. DENNIS MICHAEL JACKCredential: FNP
Location Address462 GRIDER STBuffalo, NY 14215-3021
Mailing Address6103 Woodford DrLake View, NY 14085-9457 · (716) 609-0312
Phone(716) 609-0312
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 20, 2018
Last NPPES UpdateMay 10, 20212 updates tracked since enumeration
NPPES CertifiedMay 10, 2021
✔ NPI 1659858827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 343352
462 GRIDER ST, Buffalo, NY 14215
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Dennis Michael Jack Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678822939
PECOS Enrollment IDI20180820001666
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
327 services113 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
16 services14 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kaleida Health

Acute Care Hospitals · Buffalo, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330005
Location100 High StreetBuffalo, NY 14210 · Erie County
Emergency services Birthing friendly

Olean General Hospital

Acute Care Hospitals · Olean, NY
1/5 CMS rating
OwnershipProprietary
CMS Certification Number330103
Location515 Main StreetOlean, NY 14760 · Cattaraugus County
Emergency services Birthing friendly

Rochester General Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330125
Location1425 Portland AvenueRochester, NY 14621 · Monroe County
Emergency services Birthing friendly

Erie County Medical Center

Acute Care Hospitals · Buffalo, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number330219
Location462 Grider StreetBuffalo, NY 14215 · Erie County
Emergency services

Brooks-Tlc Hospital System, Inc

Acute Care Hospitals · Dunkirk, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330229
Location529 Central AvenueDunkirk, NY 14048 · Chautauqua County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.88
Improvement Activities40
Cost63.01

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Azathioprine, oral, 50 mg J7500
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers14 claims600 services$1.18 avg. paid by Medicare
Cyclosporine, oral, 100 mg J7502
Treatment-Treatment - Miscellaneous · category RX029N
11 suppliers67 claims5,114 services$1.60 avg. paid by Medicare
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
6 suppliers57 claims27,780 services$1.19 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
38 suppliers293 claims54,975 services$0.31 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
22 suppliers212 claims43,860 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
15 suppliers125 claims21,150 services$0.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. V. THOMAS CHAPIN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000
DR. JOHN JACOB HANNIBAL IV M.D.
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-4226
HMB PHARMACY MANAGEMENT LLC
Pharmacy (Community/Retail Pharmacy)
462 GRIDER ST, DRIVEWAY 3
BUFFALO, NY 14215
Erie County (716) 332-2866
SARAH MARIE THOMPSON PA-C
Physician Assistant
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 698-5375
MATTHEW GARRETT ALBEN DO
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-5053
DANNY ISSAM BELMONA MD
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000
ALEXANDRA VAZQUEZ AGACNP
Nurse Practitioner (Acute Care)
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000
MR. KENNETH L DZIALAK COTA
Occupational Therapy Assistant
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3575

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dennis Jack's NPI number?

The NPI number for Dennis Jack is 1659858827. It was assigned to this individual provider in the NPPES registry on July 20, 2018.

Where is Dennis Jack located?

Dennis Jack practices at 462 Grider St, Buffalo, NY 14215. The listed phone number is (716) 609-0312.

What is Dennis Jack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Dennis Jack enrolled in Medicare?

Yes. Dennis Jack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Dennis Jack affiliated with any hospitals?

According to CMS data, Dennis Jack is affiliated with Kaleida Health, Olean General Hospital, Rochester General Hospital, Erie County Medical Center and Brooks-Tlc Hospital System, Inc.

When was this NPI record last updated?

The NPPES record for Dennis Jack was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.