NPIMap

Individual provider Active NPI

Jessica Martinolich

  • Surgery Physician
  • Williamsville, NY
National Provider Identifier
1154740199
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.140194 Issued in OH
Practice address
1150 Youngs Rd Ste 205
Williamsville, NY 14221-8024
Phone
(716) 636-9004
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 35.140194 OH Primary

Addresses

Primary practice location

1150 Youngs Rd Ste 205
Williamsville, NY 14221-8024

Mailing address

1150 Youngs Rd Ste 205
Williamsville, NY 14221-8024
Phone (716) 636-9004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210319001074 NY Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 6901213891 Reassigns benefits to 2 organizations
I20260617002379 FL Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 6901213891

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, shared by 5 NPIs, 1,886 clinicians
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (866) 696-2333

888 Ctr Rd
West Seneca, NY 14224-2218
Phone (716) 636-9004

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy81
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC Single Specialty CurrentSince Aug 2, 2021 Accepting new patients
University at Buffalo Surgeons Inc Single Specialty CurrentSince May 1, 2021 Accepting new patients
Ub Family Medicine, Inc Single Specialty Current Accepting new patients
Kaleida Health Past Accepting new patients

Locations

77 Goodell St
Ste 240
Buffalo, NY 14203
Phone (716) 816-7228

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

2450 Elmwood Ave
Kenmore, NY 14217
Phone (716) 873-7335

888 Center Rd
West Seneca, NY 14224
Phone (716) 675-3530

111 N Maplemere Rd
Ste 150
Williamsville, NY 14221
Phone (716) 626-2644

1150 Youngs Rd
Ste 205
Williamsville, NY 14221
Phone (716) 636-9056

Interoperability endpoints

  • Direct secure messaging: jmartinolich@gppc.medentdirect.com
  • Direct secure messaging: jessicamartinolich@ubmd.allscriptsdirect.net

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1154740199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 YOUNGS RD STE 205",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218024",
            "telephone_number": "716-636-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 YOUNGS RD STE 205",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218024",
            "telephone_number": "716-636-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINOLICH",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.140194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.