Individual provider Active NPI

John Georgiou Buchlis, MD

  • Pediatric Endocrinology Physician
  • Buffalo, NY
National Provider Identifier
1144303579
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
196898 Issued in NY
Practice address
1001 Main St FL 4
Buffalo, NY 14203-1009
Phone
(716) 323-0170
Fax
(716) 323-0297
NPI assigned
Oct 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 196898 NY
Pediatric Endocrinology Physician 2080P0205X 196898 NY Primary

Addresses

Primary practice location

1001 Main St FL 4
Buffalo, NY 14203-1009

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0170

Other identifiers 6

IdentifierTypeStateIssuer
IHAOther4509252
00010306101OtherUNIVERA
000524880001OtherBC/BS
0016886330001MedicaidPA
01752170MedicaidNY
040426001452OtherFIDELIS

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
I20050110000407 NY Practitioner - EndocrinologyPractitioner - Pediatric Medicine 9830147503 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196898NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc Pediatrics CurrentSince Jun 30, 1997 Accepting new patients

Locations

219 Bryant St
Buffalo, NY 14222
Phone (716) 878-7000

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

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

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

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

Organizations & group practices 1

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": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1144303579",
    "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": "716-323-0170",
            "fax_number": "716-323-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0170",
            "fax_number": "716-323-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHLIS",
        "first_name": "JOHN",
        "middle_name": "GEORGIOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "196898",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "196898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4509252",
            "identifier": "IHA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010306101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000524880001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016886330001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01752170",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426001452",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.