Individual provider Active NPI

Nirmala Tasgaonkar, BDS, MDS

  • Dentist
  • Buffalo, NY
National Provider Identifier
1093987158
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056390 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-2989
Phone
(716) 845-2300
NPI assigned
Mar 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 056390 NY
Dentist 122300000X 056390 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-2989

Mailing address

625 Elmwood Ave
Box 683
Rochester, NY 14620-2989
Phone (585) 436-2271

Other practice location 1

625 Elmwood Ave
Box 683
Rochester, NY 14620-2989
Phone (585) 436-2271

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
I20190318001503 NY Practitioner - Maxillofacial Surgery 5799080750 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056390NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Jan 2, 2019 Accepting new patients
State of New York Comptrollers Office CurrentSince Oct 1, 2024 Accepting new patients
State of New York Comptrollers Office CurrentSince Oct 1, 2024 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jan 2, 2019 Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

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.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1093987158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "address_2": "BOX 683",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202989",
            "telephone_number": "585-436-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142632989",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Elmwood Ave",
            "address_2": "Box 683",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202989",
            "country_code": "US",
            "telephone_number": "585-436-2271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TASGAONKAR",
        "first_name": "NIRMALA",
        "credential": "BDS, MDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "056390",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.