Individual provider Active NPI

Paul B Wirth, MD

  • MOHS-Micrographic Surgery Physician
  • Williamsville, NY
National Provider Identifier
1093766412
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
179282-1 Issued in NY
Practice address
425 Essjay Rd Ste 180
Williamsville, NY 14221
Phone
(716) 630-1140
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 179282-1 NY Primary

Addresses

Primary practice location

425 Essjay Rd Ste 180
Williamsville, NY 14221

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-5782
Phone (716) 630-1219

Other identifiers 10

IdentifierTypeStateIssuer
161000580OtherNYNOVA
161000580OtherNYNORTH AMERICAN PREFERRED
01480299MedicaidNY
070008309OtherNYRR MEDICARE
0021748OtherNYGHI
000523271001OtherNYHEALTH NOW
0306229OtherNYIHA
179282-9WOtherNYWORKERS COMPENSATION
161000580OtherNYEMPIRE
00010190601OtherNYUNIVERA

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
I20031211001046 NY Practitioner - Dermatology 6204732985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York at Buffalo School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

425 Essjay Rd
Williamsville, NY 14221-5782
Phone (716) 630-1000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision332
Removal of skin lesions28
Removal of skin cancer2262
Removal of nail tissue1-10
Removal or shaving of skin growth12
Skin biopsy292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179282-1NYMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. CurrentSince Jun 1, 1994 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jun 1, 1994 Accepting new patients

Locations

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

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

425 Essjay Rd
Ste 180
Williamsville, NY 14221
Phone (716) 630-1140

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

Interoperability endpoints

  • Direct secure messaging: pwirth155@direct.buffalomedicalgroup.com
  • Direct secure messaging: production@direct.buffalomedicalgroup.com

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1093766412",
    "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": "142215782",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 180",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-630-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "PAUL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "179282-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN PREFERRED",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01480299",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070008309",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0021748",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000523271001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "0306229",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "179282-9W",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010190601",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "425 Essjay Rd Ste 180",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.