NPIMap

Organization Active NPI

Susan Baldassari MD

  • Internal Medicine Physician
  • Kenmore, NY
National Provider Identifier
1134516735
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
167163-1 Issued in NY
Legal business name
SUSAN BALDASSARI MD
Practice address
3673 Delaware Ave
Kenmore, NY 14217-1113
Phone
(716) 871-0003
Fax
(716) 871-0266
NPI assigned
Apr 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Susan Baldassari, MDNPI 1245270388
Title
MD/Sole Proprietor
Phone
(716) 871-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 167163-1 NY Primary

Addresses

Primary practice location

3673 Delaware Ave
Kenmore, NY 14217-1113

Mailing address

3673 Delaware Ave
Kenmore, NY 14217-1113
Phone (716) 871-0003

National Provider Directory

National Provider Directory

Locations

3673 Delaware Ave
Kenmore, NY 14217
Phone (716) 839-8880

Practitioners & affiliated clinicians

Practitioners 3

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": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1134516735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171113",
            "telephone_number": "716-871-0003",
            "fax_number": "716-871-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3673 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171113",
            "telephone_number": "716-871-0003",
            "fax_number": "716-871-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN BALDASSARI MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "BALDASSARI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MD/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "716-871-0003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "167163-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.