Individual provider Active NPI

Nicole L Symons, MD

  • Family Medicine Physician
  • Williamsville, NY
National Provider Identifier
1255314456
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1255314456 Issued in NY
Practice address
325 Essjay Rd
Suite 110
Williamsville, NY 14221
Phone
(716) 630-1465
Fax
(716) 250-5989
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1255314456 NY Primary

Addresses

Primary practice location

325 Essjay Rd
Suite 110
Williamsville, NY 14221

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-5782
Phone (716) 630-1219

Other identifiers 6

IdentifierTypeStateIssuer
0114261OtherNYIHA
00028085701OtherNYUNIVERA
000593561003OtherNYHEALTH NOW
161000580OtherNYEMPIRE
161000580OtherNYMERITAIN
02878357MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000709 NY Practitioner - Family Practice 5395839534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

325 Essjay Rd
Williamsville, NY 14221-8243
Phone (716) 630-1000

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1255314456NYMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: nsymons1605@direct.buffalomedicalgroup.com

Organizations & group practices 1

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.

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1255314456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215782",
            "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": "325 ESSJAY RD",
            "address_2": "SUITE 110",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-630-1465",
            "fax_number": "716-250-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMONS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "1255314456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "0114261",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00028085701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000593561003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERITAIN",
            "identifier": "161000580",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02878357",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "325 Essjay Rd",
            "address_2": "Suite 110",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.