Individual provider Active NPI

Mohammad T. Jaffri, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1114967486
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203272 Issued in NY
Practice address
1263 Delaware Avenue
Brylin Hospitals
Buffalo, NY 14209
Phone
(716) 886-8200
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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 203272 NY Primary

Addresses

Primary practice location

1263 Delaware Avenue
Brylin Hospitals
Buffalo, NY 14209

Mailing address

8162 Golden Oak Cir
Williamsville, NY 14221-8502
Phone (716) 688-6309

Other identifiers 4

IdentifierTypeStateIssuer
0110490OtherNYINDEPENDENT HEALTH
00010303802OtherNYUNIVERA
000524685004OtherNYBLUE CROSS
01775740MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000642 NY Practitioner - Family Practice 1951366863 Practice locations: Buffalo, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203272NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1114967486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8162 GOLDEN OAK CIR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218502",
            "telephone_number": "716-688-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 DELAWARE AVENUE",
            "address_2": "BRYLIN HOSPITALS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14209",
            "telephone_number": "716-886-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFRI",
        "first_name": "MOHAMMAD",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "203272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0110490",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010303802",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000524685004",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01775740",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.