Active NPI
Pediatric Urology of Western New York P C
- Urology Physician
- Buffalo, NY
National Provider Identifier
1104962737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 141541
- Legal business name
- PEDIATRIC UROLOGY OF WESTERN NEW YORK P C
- Practice address
- 100 High St, #C2
Buffalo, NY 14203 - Phone
- (716) 859-7978
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pierre E Williot, M.D.
- Title
- Physician
- Phone
- (716) 859-7978
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 141541 | NY | Primary |
| Urology Physician | 208800000X | 231942 | NY | |
| Pediatric Urology Physician | 2088P0231X | 141541 | NY |
Addresses
Primary practice location
100 High St, #C2
Buffalo, NY 14203
Mailing address
65 Lebrun Circle
Eggertsville, NY 14226-4120
Phone (716) 878-7393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01376347 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
3580 Sheridan Dr
Buffalo, NY 14226
Phone (716) 362-9730
100 High St
#C2
Buffalo, NY 14203
Phone (716) 859-7978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587340800000",
"number": "1104962737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 LEBRUN CIRCLE",
"city": "EGGERTSVILLE",
"state": "NY",
"postal_code": "142264120",
"telephone_number": "716-878-7393",
"fax_number": "716-878-7096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HIGH ST, #C2",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14203",
"telephone_number": "716-859-7978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC UROLOGY OF WESTERN NEW YORK P C",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-30",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A",
"authorized_official_last_name": "WILLIOT",
"authorized_official_first_name": "PIERRE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "716-859-7978",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "NY",
"license": "141541",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "NY",
"license": "231942",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Urology, Pediatric Urology",
"state": "NY",
"license": "141541",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01376347",
"state": "NY"
}
],
"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 Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.