Individual provider Active NPI

Jesse Michael Imes, PHARM. D

  • Pharmacist
  • Buffalo, NY
National Provider Identifier
1104139146
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
054688 Issued in NY
Practice address
2626 Delaware Ave
Buffalo, NY 14216-1737
Phone
(513) 673-7935
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054688 NY Primary

Addresses

Primary practice location

2626 Delaware Ave
Buffalo, NY 14216-1737

Mailing address

2626 Delaware Ave
Buffalo, NY 14216-1737
Phone (513) 673-7935

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
054688NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1104139146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161737",
            "telephone_number": "513-673-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161737",
            "telephone_number": "513-673-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMES",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.