Individual provider Active NPI

Marcelle Ann Mostert, M.D.

  • Psychiatry Physician
  • Buffalo, NY
National Provider Identifier
1215020235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
166329 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-3255
Fax
(716) 898-3658
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

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
Psychiatry Physician 2084P0800X 166329 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3255

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
I20111019000757 NY Practitioner - Psychiatry 8628240520 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166329NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County South East Corp V CurrentSince Jan 9, 2003 Accepting new patients

Locations

2040 Seneca St
Buffalo, NY 14210
Phone (716) 828-0560

800 Main St
Ste 4C
Niagara Falls, NY 14301
Phone (715) 278-9640

227 Thorn Ave
Orchard Park, NY 14127
Phone (716) 539-6737

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215020235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-3255",
            "fax_number": "716-898-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-3255",
            "fax_number": "716-898-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTERT",
        "first_name": "MARCELLE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "166329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.