Individual provider Active NPI

Matthew Mazurczak, RPA-C

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1164539391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010051 Issued in NY
Practice address
100 Corporate Pkwy
Suite 112
Amherst, NY 14226-1200
Phone
(716) 839-5858
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 010051 NY Primary

Addresses

Primary practice location

100 Corporate Pkwy
Suite 112
Amherst, NY 14226-1200

Mailing address

100 Corporate Pkwy
Suite 112
Amherst, NY 14226-1200
Phone (716) 839-5858

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
I20041111000348 NY Practitioner - Physician Assistant 6002879905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1597 Elmwood Ave
Buffalo, NY 14207-3017
Phone (716) 262-3161

2980 Sheridan Dr
Tonawanda, NY 14150-9417
Phone (716) 262-3377

3190 Niagara Falls BVLD
Amherst, NY 14228-1639
Phone (716) 799-8190

3450 Union Rd
Cheektowaga, NY 14225-5120
Phone (716) 395-2043

3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 929-2800

4827 Transit Rd
Depew, NY 14043-4788
Phone (716) 771-3394

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010051NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Jun 15, 2008 Accepting new patients

Locations

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164539391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE PKWY",
            "address_2": "SUITE 112",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261200",
            "telephone_number": "716-839-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORPORATE PKWY",
            "address_2": "SUITE 112",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261200",
            "telephone_number": "716-839-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZURCZAK",
        "first_name": "MATTHEW",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.