Active NPI
Academic Buffalonias in Physical Medicine & Rehabilitation PC
- Physical Medicine & Rehabilitation Physician
- Buffalo, NY
National Provider Identifier
1063711992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 216631
- Legal business name
- ACADEMIC BUFFALONIAS IN PHYSICAL MEDICINE & REHABILITATION PC
- Practice address
- 2121 Main St
Suite 112
Buffalo, NY 14214-2693 - Phone
- (716) 832-1000
- Fax
- (716) 832-1001
- NPI assigned
- Mar 17, 2011
- Last updated
- Oct 4, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary G Wang, M.D.
- Title
- President
- Phone
- (716) 832-1000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 216631 | NY | Primary |
Addresses
Primary practice location
2121 Main St
Suite 112
Buffalo, NY 14214-2693
Mailing address
2121 Main St
Suite 210 Seton BLDG.
Buffalo, NY 14214-2693
Phone (716) 832-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J100050852 | Other | NY | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2121 Main St
Ste 210
Buffalo, NY 14214
Phone (716) 832-1000
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Medicine & Rehabilitation Physician
- Buffalo, NY
- NPI 1053382051
-
- Psychiatry Physician
- Buffalo, NY
- NPI 1285760819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1380844800000",
"number": "1063711992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 MAIN ST",
"address_2": "SUITE 210 SETON BLDG.",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142693",
"telephone_number": "716-832-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 MAIN ST",
"address_2": "SUITE 112",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142693",
"telephone_number": "716-832-1000",
"fax_number": "716-832-1001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACADEMIC BUFFALONIAS IN PHYSICAL MEDICINE & REHABILITATION PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-17",
"last_updated": "2013-10-04",
"status": "A",
"authorized_official_last_name": "WANG",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "716-832-1000",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NY",
"license": "216631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "J100050852",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
- Aziz Beyan Abubeker
- Vanessa Chinemelum Abudei
- Barilee Blessing Abueh, O.D, M.D
- Shadi Issa Ahmad Abuhashem, MBBCH
- Hamza Abuzenah, M.D.
- Academic Health Psychology Associates, P.C.
- Access Social Adult Day Care (Buffalo Social Adult Day Care)
- Carrie Ann Accordino, RN
- Accutheranostics, Inc
- Acer Transportation Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.