Individual provider Active NPI

Joseph R Takats III, DO

  • Emergency Medicine Physician
  • North Tonawanda, NY
National Provider Identifier
1083705776
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
111714 Issued in NY
Practice address
445 Tremont Street
North Tonawanda, NY 14120
Phone
(716) 694-4500
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 111714 NY Primary
Urgent Care Clinic/Center 261QU0200X 111714 NY

Addresses

Primary practice location

445 Tremont Street
North Tonawanda, NY 14120

Mailing address

50 Alcona Ave
Amherst, NY 14226-2201
Phone (716) 447-8868

Other identifiers 2

IdentifierTypeStateIssuer
040426001008OtherNYFIDELIS
00653470MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111714NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FDR Medical Services P.C. Emergency Medicine Past Accepting new patients
Twin City Physicians Group P.C. Emergency Medicine PastSince Jul 16, 1980 Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1083705776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALCONA AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262201",
            "telephone_number": "716-447-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 TREMONT STREET",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "14120",
            "telephone_number": "716-694-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKATS",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "111714",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "111714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426001008",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653470",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.