Active NPI
Mary K McGorray, MD
- Internal Medicine Physician
- Williamsville, NY
National Provider Identifier
1063470003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 192032-1
- Practice address
- 295 Essjay Rd
Williamsville, NY 14221-8216 - Phone
- (716) 630-1159
- Fax
- (716) 250-5950
- NPI assigned
- May 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 192032-1 | NY | Primary |
Addresses
Primary practice location
295 Essjay Rd
Williamsville, NY 14221-8216
Mailing address
6255 Sheridan Dr
Suite 304
Williamsville, NY 14221-4836
Phone (716) 857-8666
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000523035004 | Other | NY | HEALTH NOW |
| 110170246 | Other | NY | RR MEDICARE |
| 00010114501 | Other | NY | UNIVERA |
| 01481938 | Medicaid | NY | |
| 0405585 | Other | NY | IHA |
| 161000580 | Other | NY | EMPIRE |
| 161000580 | Other | NY | NOVA |
| 161000580 | Other | NY | NORTH AMERICAN PREFERRED |
| 161000580 | Other | NY | AETNA |
| 192032-1W | Other | NY | WORKERS COMPENATION |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140321000644 | NY | Order and Referring Only - Internal Medicine | 5092946772 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 192032-1 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240531200000",
"number": "1063470003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 SHERIDAN DR",
"address_2": "SUITE 304",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214836",
"telephone_number": "716-857-8666",
"fax_number": "716-857-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 ESSJAY RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142218216",
"telephone_number": "716-630-1159",
"fax_number": "716-250-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGORRAY",
"first_name": "MARY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2009-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "192032-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NOW",
"identifier": "000523035004",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110170246",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00010114501",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01481938",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA",
"identifier": "0405585",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOVA",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICAN PREFERRED",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENATION",
"identifier": "192032-1W",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.