Individual provider Active NPI

Paul Joseph Wirth

  • Dermatology Physician
  • Orchard Park, NY
National Provider Identifier
1053846691
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
314160 Issued in NY
Practice address
3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone
(716) 656-4477
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 314160 NY
Dermatology Physician 207N00000X 314160 NY Primary

Addresses

Primary practice location

3900 N Buffalo St
Orchard Park, NY 14127-1842

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1420

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
I20220217000041 NY Practitioner - Dermatology 8921491861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 630-1000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision707
Removal of skin lesions138
Removal of skin cancer871
Removal or shaving of skin growth1-10
Skin biopsy164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
314160NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. CurrentSince Feb 11, 2022 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Feb 11, 2022 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

425 Essjay Rd
Ste 180
Williamsville, NY 14221
Phone (716) 630-1140

425 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • Direct secure messaging: pwirth14120@direct.buffalomedicalgroup.com

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1053846691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271842",
            "telephone_number": "716-656-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2157 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142142648",
            "country_code": "US",
            "telephone_number": "716-862-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "314160",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "314160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.