Individual provider Active NPI

Anthony Mirabella, D.O.

  • Diagnostic Radiology Physician
  • Williamsville, NY
National Provider Identifier
1073925673
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
295890 Issued in NY
Practice address
295 Essjay Rd
Williamsville, NY 14221-8216
Phone
(716) 630-1112
Fax
(716) 631-0584
NPI assigned
May 30, 2014
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 295890 NY Primary

Addresses

Primary practice location

295 Essjay Rd
Williamsville, NY 14221-8216

Mailing address

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

Other practice location 1

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 630-1112

Other practice location 2

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

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
I20191002001117 NY Practitioner - Diagnostic Radiology 0345570446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians
Radiologists of Univ of RochesterGroup PAC ID 6800700170, 140 clinicians

Practice addresses (Care Compare)

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 630-1000

4901 Lac de Ville Blvd
Suite 140
Rochester, NY 14618-5649
Phone (585) 784-2985

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.74 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
56.21

Merit-based Incentive Payment System (MIPS)

Final score
91.31 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
83.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295890NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St James Hospital CurrentSince Jul 1, 2020 Accepting new patients
Buffalo Medical Group, P.C. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jul 1, 2020 Accepting new patients

Locations

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

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

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

295 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1050

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

Interoperability endpoints

  • Direct secure messaging: amirabella111121@direct.urmc.rochester.edu
  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1073925673",
    "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": "295 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218216",
            "telephone_number": "716-630-1112",
            "fax_number": "716-631-0584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 N Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271842",
            "country_code": "US",
            "telephone_number": "716-630-1112",
            "fax_number": "716-631-0584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Roe Ave",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051629",
            "country_code": "US",
            "telephone_number": "607-737-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABELLA",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-30",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "295890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "3900 N Buffalo St",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.