Bryan St Marie

Primary specialty

DentistTaxonomy code 122300000X

License

058316-1 Issued in NY

Practice address

3435 Main St #32
Buffalo, NY 14214

Phone

(716) 662-7183

NPI assigned

Mar 21, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1275995102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SILENT MEADOW",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST #32",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-662-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST MARIE",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-21",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058316-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nagaraja R Sridhar, MD
• Christopher Sroka
• Raymond David Sroka, MD
• St Catherine Laboure Medical Adult Day Healthcare Program
• St Francis Geriatric & Healthcare Facility
• St Marys Manor
• Carissa Marie St. John
• St. Lucie Gastrointestinal Diseases PL
• Raymond St. Marie, M.D.
• St. Mary'S School for the Deaf

• Dentist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.