Individual provider Active NPI

Philip Vanpeursem, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1063847283
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-3478
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

462 Grider St
Buffalo, NY 14215-3021

Other names 1

  • Philip Van Peursem Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511001869 NY Practitioner - Physician Assistant 3779804463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
76.13
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1063847283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANPEURSEM",
        "first_name": "PHILIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILIP",
            "last_name": "VAN PEURSEM",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.