NPIMap

Individual provider Active NPI

Mark D Wilkowski, PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Cheektowaga, NY
National Provider Identifier
1164479150
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
005836-1 Issued in NY
Practice address
2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone
(716) 204-4500
Fax
(716) 204-4501
NPI assigned
May 27, 2006
Last updated
Nov 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 005836-1 NY Primary

Addresses

Primary practice location

2605 Harlem Rd
Cheektowaga, NY 14225-4018

Mailing address

6653 Main St
Williamsville, NY 14221-5906
Phone (716) 204-4500

Other identifiers 1

IdentifierTypeStateIssuer
02345444MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061107000404 NY Practitioner - Physician Assistant 2567477417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wny Medical PCGroup PAC ID 9335191733, 44 clinicians

Practice addresses (Care Compare)

147 Reist St
Williamsville, NY 14221-5321
Phone (716) 633-5400

3320 N Benzing Rd
Orchard Park, NY 14127-1538
Phone (716) 825-0300

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

6970 Erie Rd
Derby, NY 14047-9591
Phone (716) 947-9147

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3381AZMDPsychologist
005836-1NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Aug 18, 2010 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Aug 18, 2010 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Dec 1, 2018 Accepting new patients
Emergency Physician Services of New York, P.C. Past Accepting new patients
Exigence Arizona LLC Emergency Medical Services Past Accepting new patients
Exigence Medical of Olean, PLLC Emergency Medical Services Past Accepting new patients
Exigence Medical of Jamestown PLLC Past Accepting new patients
MFHS Physicians' Emergency Services, PC Past Accepting new patients
Exigence of Bradford LLC Past Accepting new patients
University Emergency Medical Services Inc. Past Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

3669 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 662-0500

Organizations & group practices 11

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.

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1164479150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6653 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215906",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254018",
            "telephone_number": "716-204-4500",
            "fax_number": "716-204-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKOWSKI",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "005836-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02345444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.