Active NPI
Timothy Jeremy Joshua Balkaran, MD
- Psychiatry Physician
- Buffalo, NY
National Provider Identifier
1205255676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 300564
- Practice address
- 430 Niagara St
Buffalo, NY 14201-1886 - Phone
- (716) 853-1335
- NPI assigned
- Apr 14, 2014
- Reactivated
- May 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 300564 | NY | Primary |
Addresses
Primary practice location
430 Niagara St
Buffalo, NY 14201-1886
Mailing address
255 Delaware Ave FL 3
Buffalo, NY 14202-2016
Phone (716) 842-0440
Other practice location 1
2028 Waycross Cres
Mississauga, Ontario L5K 1H9
CA
Phone (716) 250-1112
Other practice location 2
3350 Main St
Buffalo, NY 14214-1316
Phone (716) 835-4011
Other practice location 3
1000 Main St
Buffalo, NY 14202-1102
Phone (716) 881-2405
Other practice location 4
951 Niagara St
Buffalo, NY 14213-2116
Phone (716) 884-0700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300564 | NY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1205255676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 DELAWARE AVE FL 3",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142022016",
"telephone_number": "716-842-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 NIAGARA ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142011886",
"telephone_number": "716-853-1335"
}
],
"practiceLocations": [
{
"address_1": "2028 Waycross Cres",
"address_purpose": "LOCATION",
"city": "Mississauga",
"state": "Ontario",
"postal_code": "L5K 1H9",
"country_code": "CA",
"telephone_number": "716-250-1112",
"country_name": "Canada",
"address_type": "FGN"
},
{
"address_1": "3350 Main St",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "142141316",
"country_code": "US",
"telephone_number": "716-835-4011",
"fax_number": "716-835-0253",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 Main St",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "142021102",
"country_code": "US",
"telephone_number": "716-881-2405",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "951 Niagara St",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "142132116",
"country_code": "US",
"telephone_number": "716-884-0700",
"fax_number": "716-883-7534",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALKARAN",
"first_name": "TIMOTHY",
"middle_name": "JEREMY JOSHUA",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-14",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"deactivation_date": "2014-11-17",
"reactivation_date": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "300564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.