Individual provider Active NPI

Pieter Schuyler Vanhorn, MPAS, RPA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1124469432
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012783 Issued in NY
Practice address
6 Fountain PLZ
Buffalo, NY 14202-2211
Phone
(716) 308-2557
NPI assigned
Jul 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012783 NY Primary
Physician Assistant 363A00000X OA002466 PA

Addresses

Primary practice location

6 Fountain PLZ
Buffalo, NY 14202-2211

Mailing address

22 Woodstock Rd
Glenwood, NY 14069-9631
Phone (716) 462-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140403000383 NY Practitioner - Physician Assistant 7113158296
I20250905001862 DC Practitioner - Physician Assistant 7113158296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

11915 Georgia Ave
Wheaton, MD 20902-2065
Phone (301) 942-4505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA002466PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Oct 1, 2019 Accepting new patients
Medstar Urgent Care LLC CurrentSince Aug 24, 2025 Accepting new patients
Medstar Urgent Care LLC CurrentSince Aug 24, 2025 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1124469432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WOODSTOCK RD",
            "city": "GLENWOOD",
            "state": "NY",
            "postal_code": "140699631",
            "telephone_number": "716-462-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FOUNTAIN PLZ",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142022211",
            "telephone_number": "716-308-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHORN",
        "first_name": "PIETER",
        "middle_name": "SCHUYLER",
        "name_prefix": "Mr.",
        "credential": "MPAS, RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012783",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.