Individual provider Active NPI

Robert K Brown, M.D.

  • Orthopaedic Hand Surgery Physician
  • Williamsville, NY
National Provider Identifier
1154321396
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
193194 Issued in NY
Practice address
192 Park Club LN
Suite 100
Williamsville, NY 14221-5242
Phone
(716) 204-1101
Fax
(716) 204-0914
NPI assigned
Jul 29, 2005
Last updated
Aug 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 193194 NY Primary

Addresses

Primary practice location

192 Park Club LN
Suite 100
Williamsville, NY 14221-5242

Mailing address

192 Park Club LN
Suite 100
Williamsville, NY 14221-5242
Phone (716) 204-1101

Other practice location 1

400 N Main St
Warsaw, NY 14569-1025
Phone (585) 786-1555

Other identifiers 5

IdentifierTypeStateIssuer
00020266201OtherNYUNIVERA ID#
COS193194OtherNYNYS WORKERS COMPENSATION
000524905001OtherNYBLUE CROSS BLUE SHIELD ID
01789160MedicaidNY
0909595OtherNYINDEPENDENT HEALTH ID #

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
I20120202000464 NY Practitioner - Orthopedic Surgery 6305871138

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hand & Upper Extremity Surgery, PC Hand Surgery PastSince Jan 13, 1998 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1154321396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215242",
            "telephone_number": "716-204-1101",
            "fax_number": "716-204-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215242",
            "telephone_number": "716-204-1101",
            "fax_number": "716-204-0914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Main St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NY",
            "postal_code": "145691025",
            "country_code": "US",
            "telephone_number": "585-786-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NY",
            "license": "193194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA  ID#",
            "identifier": "00020266201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS WORKERS COMPENSATION",
            "identifier": "COS193194",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "000524905001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01789160",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH ID #",
            "identifier": "0909595",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.