Organization Active NPI

Buffalo Niagara Retina Associates, PC

  • Specialist
  • Williamsville, NY
National Provider Identifier
1124265376
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2358341 Issued in NY
Legal business name
BUFFALO NIAGARA RETINA ASSOCIATES, PC
Practice address
6480 Main St
Siute #1
Williamsville, NY 14221-5852
Phone
(716) 631-3300
Fax
(716) 631-3303
NPI assigned
Jan 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Ms. Dawn Theurer
Title
Billing Manager
Phone
(716) 631-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 2358341 NY Primary

Addresses

Primary practice location

6480 Main St
Siute #1
Williamsville, NY 14221-5852

Mailing address

6480 Main St
Suite #1
Williamsville, NY 14221-5852
Phone (716) 631-3300

Other identifiers 1

IdentifierTypeStateIssuer
02676391MedicaidNY

National Provider Directory

National Provider Directory

Locations

220 Red Tail Rd
Ste 3
Orchard Park, NY 14127
Phone (716) 631-3300

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1124265376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 MAIN ST",
            "address_2": "SUITE #1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215852",
            "telephone_number": "716-631-3300",
            "fax_number": "716-631-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 MAIN ST",
            "address_2": "SIUTE #1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215852",
            "telephone_number": "716-631-3300",
            "fax_number": "716-631-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO NIAGARA RETINA ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "THEURER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "716-631-3300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "2358341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02676391",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.