Individual provider Active NPI

Michael R Brynildsen, PA

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1235464587
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013601 Issued in NY
Practice address
899 Main St
Buffalo, NY 14203-1109
Phone
(716) 878-2700
Fax
(716) 878-2701
NPI assigned
Oct 5, 2009
Last updated
Oct 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013601 NY Primary

Addresses

Primary practice location

899 Main St
Buffalo, NY 14203-1109

Mailing address

120 Gardenville Pkwy W
C/O Credentialing Department
West Seneca, NY 14224-1324
Phone (716) 857-6150

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091028000697 NY Practitioner - Physician Assistant 4880731538 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1751 Sheridan Dr
Tonawanda, NY 14223-1211
Phone (716) 844-7100

2340 Grand Island Blvd
Grand Island, NY 14072-3113
Phone (716) 403-3731

2980 Sheridan Dr
Tonawanda, NY 14150-9417
Phone (716) 262-3377

3450 Union Rd
Cheektowaga, NY 14225-5120
Phone (716) 395-2043

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013601NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Dec 9, 2009 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Dec 9, 2009 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jan 13, 2019 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
FDR Medical Services P.C. Past Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

3921 Harlem Rd
Amherst, NY 14226
Phone (716) 541-0550

4189 Veterans Memorial Dr
Batavia, NY 14020
Phone (585) 201-5598

3190 Niagara Falls Blvd
Buffalo, NY 14228
Phone (716) 418-7526

3450 Union Rd
Cheektowaga, NY 14225
Phone (716) 395-2043

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

4827 Transit Rd
Depew, NY 14043
Phone (716) 608-2236

3916 Vineyard Dr
Dunkirk, NY 14048
Phone (585) 944-3708

5965 Transit Rd
East Amherst, NY 14051
Phone (716) 362-1093

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

7432 Niagara Falls Blvd
Niagara Falls, NY 14304
Phone (716) 371-4260

921 Wayne St
Olean, NY 14760
Phone (716) 287-2731

3245 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 362-8777

1238 E Ridge Rd
Rochester, NY 14621
Phone (585) 537-3792

3980 Sheridan Dr
Snyder, NY 14226
Phone (716) 929-2800

1751 Sheridan Dr
Tonawanda, NY 14223
Phone (716) 541-0234

1956 Ridge Rd
West Seneca, NY 14224
Phone (716) 608-0041

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.

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1235464587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GARDENVILLE PKWY W",
            "address_2": "C/O CREDENTIALING DEPARTMENT",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241324",
            "telephone_number": "716-857-6150",
            "fax_number": "716-656-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031109",
            "telephone_number": "716-878-2700",
            "fax_number": "716-878-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYNILDSEN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.