Organization Active NPI

Podiatry Solutions of Wny PLLC

  • Podiatrist
  • Lockport, NY
National Provider Identifier
1215050463
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005864 Issued in NY
Legal business name
PODIATRY SOLUTIONS OF WNY PLLC
Practice address
6000 Brockton Dr
Suite 102
Lockport, NY 14094-9273
Phone
(716) 434-6601
Fax
(716) 434-1096
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Authorized official

Name
Dr. Jason T White, DPMNPI 1376640540
Title
Owner
Phone
(716) 434-6601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 005864 NY Primary

Addresses

Primary practice location

6000 Brockton Dr
Suite 102
Lockport, NY 14094-9273

Mailing address

6000 Brockton Dr
Suite 102
Lockport, NY 14094-9273
Phone (716) 434-6601

Other identifiers 3

IdentifierTypeStateIssuer
0052696002OtherNYBLUE CROSS
02344012MedicaidNY
0026080003OtherNYUNIVERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070411000456 NY Part B Supplier - Clinic/Group Practice 6204931710 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lockport, NY; Williamsville, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

6000 Brockton Dr
Ste 102
Lockport, NY 14094
Phone (716) 434-6601

6040 Edward Ave
Newfane, NY 14108
Phone (716) 434-6601

15 S Forest Rd
Williamsville, NY 14221
Phone (716) 204-8734

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1215050463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 BROCKTON DR",
            "address_2": "SUITE 102",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949273",
            "telephone_number": "716-434-6601",
            "fax_number": "716-434-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BROCKTON DR",
            "address_2": "SUITE 102",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949273",
            "telephone_number": "716-434-6601",
            "fax_number": "716-434-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY SOLUTIONS OF WNY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-434-6601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0052696002",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02344012",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "0026080003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.