Individual provider Active NPI

Xiaoyan Wu, MD

  • Pediatric Nephrology Physician
  • Buffalo, NY
National Provider Identifier
1053759209
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
45935 Issued in TX
Practice address
1001 Main St FL 4
Buffalo, NY 14203-1009
Phone
(716) 323-0140
Fax
(716) 323-0296
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 291391 NY
Pediatric Nephrology Physician 2080P0210X 45935 TX Primary

Addresses

Primary practice location

1001 Main St FL 4
Buffalo, NY 14203-1009

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0140

Other practice location 1

1404 Sweet Home Rd Ste 5
Amherst, NY 14228-2778
Phone (716) 639-9360

Other identifiers 2

IdentifierTypeStateIssuer
04930250MedicaidNY
2080P0210XMedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180115000079 NY Practitioner - NephrologyPractitioner - Pediatric Medicine 5991077075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University at Buffalo Pediatric Associates IncGroup PAC ID 1355235540, 13 clinicians

Practice addresses (Care Compare)

1404 Sweet Home Rd
Buffalo, NY 14228-2778
Phone (716) 932-6060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc CurrentSince Dec 1, 2017 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

1404 Sweet Home Rd
Ste 5
Amherst, NY 14228
Phone (716) 639-9360

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1400 Sweet Home Rd
Ste 5
Buffalo, NY 14228
Phone (716) 691-6283

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

Organizations & group practices 2

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": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1053759209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0140",
            "fax_number": "716-323-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0140",
            "fax_number": "716-323-0296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 Sweet Home Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142282778",
            "country_code": "US",
            "telephone_number": "716-639-9360",
            "fax_number": "716-323-0296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "XIAOYAN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NY",
            "license": "291391",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "45935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04930250",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080P0210X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.