Individual provider Active NPI

Joshua Mancini, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1164110342
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029831-01 Issued in NY
Practice address
100 High St. Section D1
Buffalo, NY 14203
Phone
(716) 422-0010
Fax
(716) 422-0018
NPI assigned
Apr 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029831-01 NY Primary

Addresses

Primary practice location

100 High St. Section D1
Buffalo, NY 14203

Mailing address

726 Exchange St Ste 710
Buffalo, NY 14210-1464
Phone (716) 852-4772

Other practice location 1

45 Spindrift Dr Ste 100
Williamsville, NY 14221-7889
Phone (716) 422-5422

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516002889 NY Practitioner - Physician Assistant 2365808409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians
Southgate Medical Group LLPGroup PAC ID 7911810189, 31 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-1400

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 712-0851

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029831-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jan 12, 2026 Accepting new patients
General Physician, PC PastSince Nov 17, 2024 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

100 High St
#D1
Buffalo, NY 14203
Phone (716) 422-0010

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

45 Spindrift Dr
Ste 100
Williamsville, NY 14221
Phone (716) 422-5422

Interoperability endpoints

  • Direct secure messaging: jmancini@smg.medentdirect.com

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1164110342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 EXCHANGE ST STE 710",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101464",
            "telephone_number": "716-852-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST. SECTION D1",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14203",
            "telephone_number": "716-422-0010",
            "fax_number": "716-422-0018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Spindrift Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142217889",
            "country_code": "US",
            "telephone_number": "716-422-5422",
            "fax_number": "716-422-5420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "JOSHUA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029831-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.