Individual provider Active NPI

Susan M Szimonisz, MD

  • Internal Medicine Physician
  • Williamsville, NY
National Provider Identifier
1285722462
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
217784-1 Issued in NY
Practice address
180 Park Club LN Ste 200
Williamsville, NY 14221-5258
Phone
(716) 634-7350
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217784-1 NY Primary
Pediatrics Physician 208000000X 217784-1 NY

Addresses

Primary practice location

180 Park Club LN Ste 200
Williamsville, NY 14221-5258

Mailing address

180 Park Club LN Ste 200
Williamsville, NY 14221-5258
Phone (716) 634-7350

Other identifiers 8

IdentifierTypeStateIssuer
2593959OtherNYGHI PPO
040426035682OtherNYFIDELIS
82659OtherNYGHI HMO
00025144201OtherNYUNIVERA
000526173001OtherNYBC/BS
02089201MedicaidNY
0411067OtherNYINDEPENDENT HEALTH
150523-DLOtherNYPREFERRED CARE

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
I20100720000532 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0941332373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
State University of New York at Buffalo School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sheridan Drive Medical Group LLPGroup PAC ID 8820900376, 9 clinicians
Buffalo ENT Specialists, LLPGroup PAC ID 6901886183, 3 clinicians

Practice addresses (Care Compare)

1491 Sheridan Dr
Suite 100
Tonawanda, NY 14217-1234
Phone 7163324476323

180 Park Club LN
Suite 200
Williamsville, NY 14221-5258
Phone (716) 634-7350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217784-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo ENT Specialists, LLP CurrentSince Jun 18, 2019 Accepting new patients
Sheridan Drive Medical Group LLP Internal Medicine CurrentSince Dec 7, 2020 Accepting new patients

Locations

85 E Main St
Fredonia, NY 14063
Phone (716) 634-7350

1491 Sheridan Dr
Ste 100
Tonawanda, NY 14217
Phone (716) 332-4476

180 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-7350

Interoperability endpoints

  • Direct secure messaging: sms@buffaloent.medentdirect.com
  • Direct secure messaging: sszimonisz@sheridanmedgroup.medentdirect.com
  • FHIR API: https://fhir.medent.com/fhir/R4/3P171181

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1285722462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215258",
            "telephone_number": "716-634-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215258",
            "telephone_number": "716-634-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZIMONISZ",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "217784-1",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "217784-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "2593959",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426035682",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "82659",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00025144201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000526173001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02089201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0411067",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "150523-DL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.