Individual provider Active NPI

Michael S Winnicki, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1013950138
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
155345 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone
(716) 845-2300
Fax
(716) 845-4693
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 155345 NY Primary
Internal Medicine Physician 207R00000X MD450188 PA

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-0001

Mailing address

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other identifiers 2

IdentifierTypeStateIssuer
01740436MedicaidNY
1028852910003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD450188PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Area Medical Associates, L.L.P. Internal Medicine Current Accepting new patients
Great Lakes Physician Practice PC Internal Medicine Current Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients

Locations

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

15 S Main St
Ste 300
Jamestown, NY 14701
Phone (716) 488-1877

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

Interoperability endpoints

  • Direct secure messaging: mwinnicki@direct.excelahealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1013950138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNICKI",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "155345",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD450188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01740436",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028852910003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.