Organization Active NPI

Pediatric Urology of Western New York P C

  • Urology Physician
  • Buffalo, NY
National Provider Identifier
1104962737
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
141541 Issued in NY
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

Updated by the provider on Apr 20, 2020

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X 141541 NY Primary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X 231942 NY
Pediatric Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
01376347MedicaidNY

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.