Individual provider Active NPI

Osama Farouq Almadhoun, M.D

  • Pediatric Gastroenterology Physician
  • Buffalo, NY
National Provider Identifier
1073728002
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
298737 Issued in NY
Practice address
1001 Main St FL 4
Buffalo, NY 14203-1009
Phone
(716) 323-0080
Fax
(716) 323-0295
NPI assigned
May 12, 2007
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 298737 NY Primary
Pediatric Gastroenterology Physician 2080P0206X 04-34794 KS

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) 323-0080

Other practice location 1

3901 Rainbow Blvd # Ks
Dept of Pediatrics, Mail Stop 3063
Kansas City, KS 66160-8500
Phone (913) 588-6326

Other identifiers 1

IdentifierTypeStateIssuer
05735135MedicaidNY

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
I20201218000306 NY Practitioner - GastroenterologyPractitioner - Pediatric Medicine 8628256997 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-34794KSMDPediatric Gastroenterology Physician
298737NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince May 20, 2024 Accepting new patients
University at Buffalo Pediatric Associates Inc CurrentSince Aug 15, 2020 Accepting new patients
Kaleida Health CurrentSince May 20, 2024 Accepting new patients

Locations

1001 Main St
Fl 2
Buffalo, NY 14203
Phone (716) 323-6380

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

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

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

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

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1073728002",
    "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": "716-323-0080",
            "fax_number": "716-323-0295"
        },
        {
            "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": "716-323-0080",
            "fax_number": "716-323-0295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd # Ks",
            "address_2": "Dept of Pediatrics, Mail Stop 3063",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-6326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALMADHOUN",
        "first_name": "OSAMA",
        "middle_name": "FAROUQ",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "298737",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "KS",
            "license": "04-34794",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05735135",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.