Active NPI
Anthony Desouza
- Family Nurse Practitioner
- Buffalo, NY
National Provider Identifier
1265890149
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 19, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 340092
- Practice address
- 462 Grider St
Buffalo, NY 14215-3021 - Phone
- (212) 810-9755
- NPI assigned
- Feb 5, 2016
- Last updated
- Feb 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 340092 | NY | Primary |
Addresses
Primary practice location
462 Grider St
Buffalo, NY 14215-3021
Mailing address
House Number 416
Bamon Bhatt
Merces, GOA 403005
IN
Phone (212) 810-9755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1265890149",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "HOUSE NUMBER 416",
"address_2": "BAMON BHATT",
"city": "MERCES",
"state": "GOA",
"postal_code": "403005",
"telephone_number": "212-810-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 GRIDER ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142153021",
"telephone_number": "212-810-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOUZA",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-05",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "340092",
"primary": true
}
],
"identifiers": [],
"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 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.