Individual provider Active NPI

Elias Liborio Manzella, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1235681404
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2228 Delaware Ave Ste 200
Buffalo, NY 14216-2618
Phone
(716) 874-2273
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2228 Delaware Ave Ste 200
Buffalo, NY 14216-2618

Mailing address

2228 Delaware Ave Ste 200
Buffalo, NY 14216-2618
Phone (716) 874-2273

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
I20200918000913 NY Practitioner - Physician Assistant 5496023509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2228 Delaware Ave
Suite 200
Buffalo, NY 14216-2618
Phone (716) 874-2273

3346 Southwestern Blvd
Orchard Park, NY 14127-1524
Phone (716) 675-3700

6375 Transit Rd
Suite 2000
Depew, NY 14043-1030
Phone (716) 684-2273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3213TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Oct 1, 2020 Accepting new patients
Trinity Medical Wny PC CurrentSince Jan 1, 2021 Accepting new patients
Trinity Medical Wny PC Physician Assistant CurrentSince Jan 1, 2021 Accepting new patients

Locations

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

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

2228 Delaware Ave
#200
Buffalo, NY 14216
Phone (716) 874-2273

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

7616 Transit Rd
Williamsville, NY 14221
Phone (716) 204-2273

Organizations & group practices 6

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1235681404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 DELAWARE AVE STE 200",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162618",
            "telephone_number": "716-874-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 DELAWARE AVE STE 200",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162618",
            "telephone_number": "716-874-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZELLA",
        "first_name": "ELIAS",
        "middle_name": "LIBORIO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.