NPIMap

Individual provider Active NPI

Ethan Kenji Craig, MD

  • Surgery Physician
  • Williamsville, NY
National Provider Identifier
1114414513
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
327603 Issued in NY
Practice address
111 N Maplemere Rd Ste 100
Williamsville, NY 14221-3182
Phone
(716) 833-7112
NPI assigned
Apr 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME162962 FL
Surgery Physician 208600000X 327603 NY Primary

Addresses

Primary practice location

111 N Maplemere Rd Ste 100
Williamsville, NY 14221-3182

Mailing address

111 N Maplemere Rd Ste 100
Williamsville, NY 14221-3182
Phone (716) 833-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240727000164 NY Practitioner - General Surgery 6204173370 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University at Buffalo Surgeons IncGroup PAC ID 4183612799, 40 clinicians

Practice addresses (Care Compare)

111 N Maplemere Rd
Suite 150
Williamsville, NY 14221-3178
Phone (716) 833-7112

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
Wyoming County Surgery Current Accepting new patients
Wyoming County Surgery CurrentSince Oct 1, 2024 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2024 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2024 Accepting new patients
University at Buffalo Surgeons Inc Surgery CurrentSince Sep 1, 2024 Accepting new patients
Wyoming County CurrentSince Oct 1, 2024 Accepting new patients
Wyoming County Surgery Current Accepting new patients
Wyoming County Past Accepting new patients
Kaleida Health Past Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

400 N Main St
Warsaw, NY 14569
Phone (585) 786-1555

111 N Maplemere Rd
Ste 100
Williamsville, NY 14221
Phone (716) 810-7997

111 N Maplemere Rd
Ste 150
Williamsville, NY 14221
Phone (716) 626-2644

Interoperability endpoints

  • Direct secure messaging: ecraig@surgeryspecialists.medentdirect.com
  • Direct secure messaging: ecraig125588@direct.med.miami.edu
  • Direct secure messaging: ethancraig@ubmd.allscriptsdirect.net

Organizations & group practices 10

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 10

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1114414513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213182",
            "telephone_number": "716-833-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213182",
            "telephone_number": "716-833-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "ETHAN",
        "middle_name": "KENJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME162962",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "327603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.