Individual provider Active NPI

Michelle Marie Myers, M.D.

  • Pediatrics Physician
  • North Tonawanda, NY
National Provider Identifier
1104261841
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
285899 Issued in NY
Practice address
2890 Niagara Falls Blvd
North Tonawanda, NY 14120-1114
Phone
(716) 807-7337
Fax
(716) 213-4400
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 285899 NY Primary

Addresses

Primary practice location

2890 Niagara Falls Blvd
North Tonawanda, NY 14120-1114

Mailing address

2890 Niagara Falls Blvd
North Tonawanda, NY 14120-1114
Phone (716) 807-7337

Other identifiers 1

IdentifierTypeStateIssuer
04790305MedicaidNY

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 Medicine

State licenses

LicenseStateTypeSpecialty
285899NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheatfield Pediatrics, LLP Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmyers@wheatfieldpediatrics.medentdirect.com

Organizations & group practices 1

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1104261841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201114",
            "telephone_number": "716-807-7337",
            "fax_number": "716-213-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201114",
            "telephone_number": "716-807-7337",
            "fax_number": "716-213-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "285899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04790305",
            "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 Apr 6, 2018; 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.