Doctor profile · Federal record

Dr. Mary Vaillancourt, CRNP

Adult Health Nurse Practitioner · Nurse Practitioner · Adult Health Nurse Practitioner · Gerontology Nurse Practitioner · Registered Nurse · Registered Nurse · Jamestown, NY

  • NPI 1104290915
  • 11 yrs on file
  • Licensed in 2 states
  • Female
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
107 Institute St
Jamestown, NY 147016628
(716) 484-4334
fax (833) 974-2029

Credentials & registration

NPPES · NUCC
NPI registered
November 2015 — 11 yrs on file
Profile last updated
August 31, 2023
Specialty taxonomy
363LA2200X — NUCC code
State licenses (4)
New York #F307302 · Pennsylvania #SP015710 · Pennsylvania #RN578441 · New York #362456

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1104290915. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
13
Distinct HCPCS
1
Medicare allowed
$124
HCPCS Description Services Patients Avg allowed
83036 Hemoglobin a1c level 13 11 $10

In context: peer comparison

Among 2 peers in this city , average services per provider: 104. This provider delivers 0.1× the peer median.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$150
Transactions
7
Manufacturers
6
Payer (manufacturer) Industry Txns Amount
ABBVIE INC. 1 $36.83
GlaxoSmithKline, LLC. 2 $30.97
Phathom Pharmaceuticals, Inc. 1 $27.73
Teva Pharmaceuticals USA, Inc. 1 $19.23
Merck Sharp & Dohme LLC 1 $17.59
Hologic Sales and Service, LLC 1 $17.39

By nature of payment

Food and Beverage
$150

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
87
Patients
28
Total drug cost
$1,530
Drug Type Claims Patients Total cost
Atorvastatin Calcium Generic 28 17 $284
Gabapentin Generic 25 0 $528
Albuterol Sulfate Hfa (Albuterol Sulfate) Brand 20 11 $642
Metformin Hcl Generic 14 0 $76

Frequently asked questions

Auto-generated from federal data
What is Dr. Mary Vaillancourt's medical specialty?
Dr. Mary Vaillancourt practices Adult Health Nurse Practitioner in Jamestown, NY.
Where does Dr. Mary Vaillancourt practice?
Dr. Mary Vaillancourt practices at 107 Institute St, Jamestown, NY 147016628. Office phone: 7164844334.
What is Dr. Mary Vaillancourt's NPI?
Dr. Mary Vaillancourt's National Provider Identifier (NPI) is 1104290915, issued by NPPES.
What procedures does Dr. Mary Vaillancourt commonly perform?
Top Medicare-reported procedures in 2023: Hemoglobin a1c level (HCPCS 83036). Source: CMS Medicare Physician & Other Practitioners file.