Breeann N Wilson, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

006328-1 Issued in NY

Practice address

1431 Hertel Ave
Buffalo, NY 14216-2871

Phone

(716) 897-3720

Fax

(716) 897-3918

NPI assigned

Mar 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: breeannwilson@ppowp-ny.direct.office.nextgen.com

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.

• Pure Podiatry of Wny PLLC

  • Podiatrist
  • Buffalo, NY
  • NPI 1114382520
  Medicare reassignment Authorized official
• Vascular-Interventional Associates, P.C.

  • Vascular & Interventional Radiology Physician
  • Lancaster, NY
  • NPI 1881735496
  Medicare reassignment NPD
• Devincentis DPM Devincentis DPM PC

  • Podiatrist
  • Buffalo, NY
  • NPI 1659562205
  NPD
• Northtown Podiatry Group PC

  • Durable Medical Equipment & Medical Supplies
  • Clarence, NY
  • NPI 1508082223
  NPD (past)

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1255573887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162871",
            "telephone_number": "716-897-3720",
            "fax_number": "716-897-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162871",
            "telephone_number": "716-897-3720",
            "fax_number": "716-897-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BREEANN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4817",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006328-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alycia M Willoughby, MSW
• Jacob Wilsen, DPT
• Lonnesha Wilson-McDaniels, CRANIAL PROSTHESES
• Kathleen Marie Wilson-Ward, AU.D
• Antoinette Wilson
• Brittany E Wilson, LPN
• Courtney Wilson
• Demaris Wilson, NP
• Jalen Wilson
• Kimberley Alexandria Wilson, NP

• Foot & Ankle Surgery Podiatrist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.