NPIMap

Individual provider Active NPI

Robert P Gatewood Jr., MD

  • Cardiovascular Disease Physician
  • Williamsville, NY
National Provider Identifier
1215915681
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
124062 Issued in NY
Practice address
425 Essjay Rd
Buffalo Medical Group, PC
Williamsville, NY 14221-5782
Phone
(716) 630-1146
Fax
(716) 817-1729
NPI assigned
Jan 5, 2006
Last updated
May 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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 124062 NY Primary

Addresses

Primary practice location

425 Essjay Rd
Buffalo Medical Group, PC
Williamsville, NY 14221-5782

Mailing address

6255 Sheridan Dr
Suite 108 - Credentialing Dept
Williamsville, NY 14221-4836
Phone (716) 630-1219

Other identifiers 4

IdentifierTypeStateIssuer
000508569001OtherBLUE CROSS COMMUNITY BLUE
660068MedicaidNY
00010060701OtherNYUNIVERA
2100905OtherINDEPENDENT HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000978 NY Practitioner - Cardiovascular Disease (Cardiology) 7810978327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Georgetown University School of Medicine, 1974
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)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124062NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pdi Health NJ LLC CurrentSince Jan 1, 2021 Accepting new patients
General Physician, PC CurrentSince Jun 28, 2021 Accepting new patients
Pdihealth MD LLC CurrentSince Jan 1, 2021 Accepting new patients
Pdi Health LLC PastSince Jan 1, 2021 Accepting new patients
Preventive Diagnostics Inc Past Accepting new patients
Western New York Ear, Nose & Throat, P.C. PastSince Jul 24, 2025 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

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

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

Organizations & group practices 7

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 6

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1215915681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR",
            "address_2": "SUITE 108 - CREDENTIALING DEPT",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214836",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD",
            "address_2": "BUFFALO MEDICAL GROUP, PC",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215782",
            "telephone_number": "716-630-1146",
            "fax_number": "716-817-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "124062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS COMMUNITY BLUE",
            "identifier": "000508569001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660068",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010060701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "2100905",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.