Individual provider Active NPI

Samantha Renee Wilhelm

  • Family Nurse Practitioner
  • Lewiston, NY
National Provider Identifier
1104303270
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343240 Issued in NY
Practice address
5300 Military Rd
Lewiston, NY 14092-1997
Phone
(716) 297-4800
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343240 NY Primary

Addresses

Primary practice location

5300 Military Rd
Lewiston, NY 14092-1997

Mailing address

8 Swallow LN
Orchard Park, NY 14127-3544
Phone (716) 903-6953

Other names 1

  • Samantha Goldbach Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181026000278 NY Practitioner - Nurse Practitioner 9931452638 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo-Niagara Hospitalists LLCGroup PAC ID 3375789050, 36 clinicians

Practice addresses (Care Compare)

2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone (716) 447-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
343240NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frank R. Laurri, M.D. & Associates, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Frank R. Laurri, M.D. & Associates, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Buffalo Emergency Associates LLP CurrentSince Mar 10, 2020 Accepting new patients
Buffalo-Niagara Hospitalists LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

10175 Niagara Falls Blvd
#1
Niagara Falls, NY 14304
Phone (716) 205-0170

3065 Southwestern Blvd
Ste 102
Orchard Park, NY 14127
Phone (716) 261-1474

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1104303270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SWALLOW LN",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273544",
            "telephone_number": "716-903-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MILITARY RD",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "140921997",
            "telephone_number": "716-297-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GOLDBACH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewiston, NY

Sources for this page

Verify at the official NPI Registry.