NPIMap

Organization Active NPI

Kenmore Pediatric Assoc., P.C.

  • Pediatrics Physician
  • Buffalo, NY
National Provider Identifier
1215957063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
111276 Issued in NY
Legal business name
KENMORE PEDIATRIC ASSOC., P.C.
Practice address
341 Englewood Ave
Buffalo, NY 14223-2819
Phone
(716) 833-2333
NPI assigned
Jul 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roger A Forden, M.D.NPI 1023083037
Title
President
Phone
(716) 833-2333

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
Pediatrics Physician 208000000X 111276 NY Primary

Addresses

Primary practice location

341 Englewood Ave
Buffalo, NY 14223-2819

Mailing address

341 Englewood Ave
Buffalo, NY 14223-2819
Phone (716) 833-2333

National Provider Directory

National Provider Directory

Locations

341 Englewood Ave
Buffalo, NY 14223
Phone (716) 833-2333

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215957063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 ENGLEWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142232819",
            "telephone_number": "716-833-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 ENGLEWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142232819",
            "telephone_number": "716-833-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMORE PEDIATRIC ASSOC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORDEN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-833-2333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "111276",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.