Pure Podiatry of Wny PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

006328 Issued in NY

Legal business name

PURE PODIATRY OF WNY PLLC

Practice address

1431 Hertel Ave
Buffalo, NY 14216-2871

Phone

(716) 897-3720

Fax

(716) 897-3918

NPI assigned

Dec 30, 2015

Organization subpart

No

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

Authorized official

Name

Breeann N Wilson, DPMNPI 1255573887

Title

Owner

Phone

(716) 897-3720

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Breeann N Wilson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Buffalo, NY
  • NPI 1255573887
  Medicare reassignment Authorized official
• Joseph Anthony De Vincentis, DPM

  • Podiatrist
  • Orchard Park, NY
  • NPI 1851315634
  NPD (past)

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1114382520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162871",
            "telephone_number": "716-897-3720",
            "fax_number": "716-897-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162871",
            "telephone_number": "716-897-3720",
            "fax_number": "716-897-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE PODIATRY OF WNY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BREEANN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-897-3720",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04485329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Gromilovitz Pung, D.O.
• Sarah Punturiero, LCSW
• Traci Punturiero, RD
• Ashley Pupovac, CCC-SLP
• Eileen Barbara Purcell, FNP
• Sumangala P Puri, M.D.
• Christopher Roy Pusateri, D.D.S.
• Cheryl Ann Putnam, MD
• Theodore Inman Putnam, MD
• Andrew Putzak

• Podiatrist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.