NPIMap

Organization Active NPI

Buffalo Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Buffalo, NY
National Provider Identifier
1104281195
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
N006292 Issued in NY
Legal business name
BUFFALO MEDICAL GROUP, P.C.
Practice address
85 High St
Buffalo, NY 14203
Phone
(716) 630-1295
Fax
(716) 250-5999
NPI assigned
Dec 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Authorized official

Name
Daniel Scully
Title
Ceo
Phone
(716) 630-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X N006292 NY Primary

Addresses

Primary practice location

85 High St
Buffalo, NY 14203

Mailing address

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

Other names 1

  • Podiatry Affiliates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160217000807 NY DME Supplier - Physician - Podiatry 7012820301 Practice locations: Buffalo, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Buffalo Medical Group PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1104281195",
    "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": "85 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14203",
            "telephone_number": "716-630-1295",
            "fax_number": "716-250-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "SCULLY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-630-2500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "N006292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Podiatry Affiliates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Podiatry Affiliates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.