NPIMap

Organization Active NPI

Delaware Pediatric Associates

  • Pediatrics Physician
  • Buffalo, NY
National Provider Identifier
1255604583
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
101753 Issued in NY
Legal business name
DELAWARE PEDIATRIC ASSOCIATES
Practice address
2550 Delaware Ave
Buffalo, NY 14216-1721
Phone
(716) 884-0230
NPI assigned
Feb 16, 2012
Last updated
Feb 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Dr. Thomas Edge Schenk, MDNPI 1235115957
Title
Partner
Phone
(716) 884-0230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 101753 NY Primary

Addresses

Primary practice location

2550 Delaware Ave
Buffalo, NY 14216-1721

Mailing address

2550 Delaware Ave
Buffalo, NY 14216-1721
Phone (716) 884-0230

Other identifiers 7

IdentifierTypeStateIssuer
00652882MedicaidNY
00963722MedicaidNY
01029556MedicaidNY
01398705MedicaidNY
02952789MedicaidNY
03357173MedicaidNY
02161773MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1255604583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161721",
            "telephone_number": "716-884-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161721",
            "telephone_number": "716-884-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "SCHENK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EDGE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "716-884-0230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "101753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00652882",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00963722",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01029556",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01398705",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02952789",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03357173",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02161773",
            "state": "NY"
        }
    ],
    "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 Feb 16, 2012; 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.