Organization Active NPI

Tonawanda Medical Services, PC

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1295924363
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214045 Issued in NY
Legal business name
TONAWANDA MEDICAL SERVICES, PC
Practice address
843 Tonawanda St
Buffalo, NY 14207-1447
Phone
(716) 536-9409
Fax
(716) 874-6660
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Authorized official

Name
Dr. Ziad I Khatib, M.D.
Title
Physician
Phone
(716) 536-9409

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 214045 NY Primary
Medical Specialty Clinic/Center 261QM2500X 214045 NY

Addresses

Primary practice location

843 Tonawanda St
Buffalo, NY 14207-1447

Mailing address

PO Box 1015
Buffalo, NY 14207-9015
Phone (716) 536-9409

Other identifiers 2

IdentifierTypeStateIssuer
AA1410OtherNYMEDICARE GROUP # AA1410
01794747MedicaidNY

National Provider Directory

National Provider Directory

Locations

843 Tonawanda St
Buffalo, NY 14207
Phone (716) 874-0511

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1295924363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1015",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142079015",
            "telephone_number": "716-536-9409",
            "fax_number": "716-689-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 TONAWANDA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071447",
            "telephone_number": "716-536-9409",
            "fax_number": "716-874-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONAWANDA MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "KHATIB",
        "authorized_official_first_name": "ZIAD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "716-536-9409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214045",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "214045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP # AA1410",
            "identifier": "AA1410",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01794747",
            "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 Jun 8, 2009; 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.