Active NPI
John B Stevens III
- Anesthesiology Physician
- Williamsville, NY
National Provider Identifier
1295741312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 141894-1
- Practice address
- 30 S Cayuga Rd
Williamsville, NY 14221-6728 - Phone
- (716) 632-1088
- Fax
- (716) 632-7842
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 141894-1 | NY | Primary |
Addresses
Primary practice location
30 S Cayuga Rd
Williamsville, NY 14221-6728
Mailing address
30 S Cayuga Rd
Williamsville, NY 14221-6728
Phone (716) 632-1088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01092891 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 141894-1 | NY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1295741312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 S CAYUGA RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216728",
"telephone_number": "716-632-1088",
"fax_number": "716-632-7842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 S CAYUGA RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216728",
"telephone_number": "716-632-1088",
"fax_number": "716-632-7842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "141894-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01092891",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.