Individual provider Active NPI

James S Collins, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1104819200
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
134888 Issued in NY
Practice address
40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 134888 NY Primary

Addresses

Primary practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344

Mailing address

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone (716) 893-1010

Other identifiers 1

IdentifierTypeStateIssuer
00758241MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050629000196 NY Practitioner - Family Practice 0446141394 Reassigns benefits to 2 organizations
I20211109000349 VT Practitioner - Family Practice 0446141394 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Mobile Medical Care PC CurrentSince Apr 1, 2025 Accepting new patients
Mobile Physician Services PLLC Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
Mobile Nurse Practitioners Past Accepting new patients
Mobile Nurse Practitioners Past Accepting new patients

Locations

640 Ellicott St
Ste 105
Buffalo, NY 14203
Phone (716) 218-7169

40 La Riviere Dr
Ste 140
Buffalo, NY 14202

40 La Riviere Dr
Ste 201A
Buffalo, NY 14202
Phone 7168931010221

40 La Riviere Dr
Ste 201
Buffalo, NY 14202
Phone 7168931010210

4650 Southwestern Blvd
Hamburg, NY 14075
Phone (716) 648-2450

5775 Maelou Dr
Hamburg, NY 14075
Phone (716) 648-2820

3333 Elmwood Ave
Kenmore, NY 14217
Phone (716) 874-1566

98 Starr Farm Rd
Burlington, VT 05408
Phone (802) 658-6717

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1104819200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JAMES",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "134888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00758241",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.