Individual provider Active NPI

Alicia Nicole Gayleen Drago, M.D.

  • Pediatrics Physician
  • Buffalo, NY
National Provider Identifier
1134865850
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
338745 Issued in NY
Practice address
818 Ellicott St.
Buffalo, NY 14203
Phone
(716) 323-2000
Fax
(716) 323-0292
NPI assigned
May 5, 2022
Reactivated
Feb 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 338745 NY Primary

Addresses

Primary practice location

818 Ellicott St.
Buffalo, NY 14203

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0225

Other practice location 1

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 568-3600

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
I20250828004564 NY Practitioner - Pediatric Medicine 6800397076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1001 Main St
FL 5
Buffalo, NY 14203-1013

1021 Broadway St
FL 2
Buffalo, NY 14212-1460

144 Genesee St
FL 3
Buffalo, NY 14203-1510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338745NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Aug 1, 2025 Accepting new patients
Kaleida Health CurrentSince Aug 1, 2025 Accepting new patients
Kaleida Health Current Accepting new patients
University at Buffalo Pediatric Associates Inc Pediatrics CurrentSince Sep 2, 2025 Accepting new patients

Locations

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1021 Broadway St
Fl 2
Buffalo, NY 14212

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

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": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1134865850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0225",
            "fax_number": "716-323-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ELLICOTT ST.",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14203",
            "telephone_number": "716-323-2000",
            "fax_number": "716-323-0292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142213647",
            "country_code": "US",
            "telephone_number": "716-568-3600",
            "fax_number": "716-323-0292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAGO",
        "first_name": "ALICIA",
        "middle_name": "NICOLE GAYLEEN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "deactivation_date": "2022-12-13",
        "reactivation_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "338745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.