Individual provider Active NPI

Reza Banifatemi, MD

  • Cardiovascular Disease Physician
  • Williamsville, NY
National Provider Identifier
1205884533
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
262789 Issued in NY
Practice address
705 Maple Rd Ste 300
Williamsville, NY 14221-3291
Phone
(716) 710-8266
Fax
(716) 710-8267
NPI assigned
May 5, 2006
Last updated
Nov 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 262789 NY Primary

Addresses

Primary practice location

705 Maple Rd Ste 300
Williamsville, NY 14221-3291

Mailing address

908 Niagara Falls Blvd Ste 208
North Tonawanda, NY 14120-2019
Phone (716) 692-3302

Other identifiers 1

IdentifierTypeStateIssuer
03390076MedicaidNY

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
I20110915000605 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9638128051 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

705 Maple Rd
Williamsville, NY 14221-3291
Phone (716) 656-4077

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.14 of 100Reported as individual
Quality
80.4
Promoting interoperability
78
Improvement activities
40
Cost
83.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262789NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jul 5, 2017 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Nov 16, 2017 Accepting new patients
Niagara Falls Memorial Medical Center Cardiovascular Disease CurrentSince Nov 16, 2017 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince May 23, 2016 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince May 23, 2016 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 631-2517

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

6255 Sheridan Dr
Ste 108
Williamsville, NY 14221
Phone (716) 630-1219

705 Maple Rd
Williamsville, NY 14221
Phone (716) 580-7300

705 Maple Rd
Ste 300
Williamsville, NY 14221
Phone (716) 631-8400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/
  • Direct secure messaging: rbanifatemi@gppc.medentdirect.com
  • Direct secure messaging: reza.banifatemi.1@8292.direct.athenahealth.com

Organizations & group practices 5

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 8

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1205884533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAPLE RD STE 300",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213291",
            "telephone_number": "716-710-8266",
            "fax_number": "716-710-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIFATEMI",
        "first_name": "REZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "262789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03390076",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.