Individual provider Active NPI

Laurie Sultz Sadler, MD

  • Pediatrics Physician
  • Buffalo, NY
National Provider Identifier
1194808535
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
177952 Issued in NY
Practice address
1001 Main St FL 4
Buffalo, NY 14203-1009
Phone
(716) 323-0040
Fax
(716) 323-0292
NPI assigned
Oct 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 177952 NY Primary

Addresses

Primary practice location

1001 Main St FL 4
Buffalo, NY 14203-1009

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0040

Other identifiers 6

IdentifierTypeStateIssuer
01163648MedicaidNY
000510827001OtherBC/BS
040426000752OtherFIDELIS
00010154001OtherUNIVERA
1205780OtherIHA
0014383090001MedicaidPA

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
I20050111000135 NY Practitioner - Pediatric MedicinePractitioner - Medical Genetics and Genomics 2062460645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Medical Genetics and Genomics
Education
State University of New York at Buffalo School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University at Buffalo Pediatric Associates IncGroup PAC ID 1355235540, 13 clinicians

Practice addresses (Care Compare)

1404 Sweet Home Rd
Buffalo, NY 14228-2778
Phone (716) 932-6060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177952NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc Pediatrics CurrentSince Jan 1, 1998 Accepting new patients

Locations

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1400 Sweet Home Rd
Ste 5
Buffalo, NY 14228
Phone (716) 691-6283

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

219 Bryant St
Buffalo, NY 14222
Phone (716) 878-7000

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

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": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1194808535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0040",
            "fax_number": "716-323-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0040",
            "fax_number": "716-323-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADLER",
        "first_name": "LAURIE",
        "middle_name": "SULTZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "177952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01163648",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000510827001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426000752",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010154001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1205780",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014383090001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.