Buffalo Beacon Corporation

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

050610689 Issued in NY

Legal business name

BUFFALO BEACON CORPORATION

Doing business as

Beacon Center

Practice address

3354 Sheridan Dr
Amherst, NY 14226-1439

Phone

(716) 831-1937

Fax

(716) 831-8837

NPI assigned

Jun 10, 2005

Last updated

May 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline L West, MBA, CASAC

Title

Chief Operating Officer

Phone

(716) 831-1937

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Beacon Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Beacon Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Buffalo Beacon Corporation

  dba The Albert O. Nichols House

  • Assisted Living Facility
  • Herkimer, NY
  • NPI 1588063549
  NPD tax ID

Locations

Practitioners 3

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.

• Corey Corbin, NP

  • Family Nurse Practitioner
  • Oneida, NY
  • NPI 1144773300
  NPD
• Richard Lee Obrien, DO

  • Family Medicine Physician
  • Gloversville, NY
  • NPI 1275589442
  NPD
• Hillary Anne Kelly, MS, FNP-C

  • Nurse Practitioner
  • Herkimer, NY
  • NPI 1386709608
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1083618672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261439",
            "telephone_number": "716-831-1937",
            "fax_number": "716-831-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261439",
            "telephone_number": "716-831-1937",
            "fax_number": "716-831-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO BEACON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "716-831-1937",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, CASAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "050610689",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NY",
            "license": "170912042",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01183233",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Joseph Buckley Jr., MD
• Glenn Robert Buczkowski, PA-C
• James L Budny, M.D.
• Buffalo Amherst Allergy Associates P.C.
• Buffalo Athletic Club Suburban, Inc.
• Buffalo Bodywork LLC
• Buffalo Diagnostic Imaging PLLC
• Buffalo Endovascular and Vascular Surgical Associates, PLLC
• Buffalo Neurosurgery P.C.
• Buffalo OBGYN, LLP

• Addiction (Substance Use Disorder) Counselor in Amherst, NY
• Providers in Amherst, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.