Individual provider Active NPI

Jeffrey Herendeen

  • Pediatrics Physician
  • Depew, NY
National Provider Identifier
1174056477
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
302218 Issued in NY
Practice address
4899 Transit Rd
Depew, NY 14043-4776
Phone
(716) 558-5437
Fax
(716) 558-5444
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 302218 NY Primary

Addresses

Primary practice location

4899 Transit Rd
Depew, NY 14043-4776

Mailing address

4899 Transit Rd
Depew, NY 14043-4776
Phone (716) 558-5437

Other practice location 1

219 Bryant St
Buffalo, NY 14222-2006
Phone (716) 878-7432

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
I20190123000481 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4880931336

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
William J Baier MD PLLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1174056477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4899 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434776",
            "telephone_number": "716-558-5437",
            "fax_number": "716-558-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4899 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434776",
            "telephone_number": "716-558-5437",
            "fax_number": "716-558-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142222006",
            "country_code": "US",
            "telephone_number": "716-878-7432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERENDEEN",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "302218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.