Individual provider Active NPI

Paula Marie Mazur, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Buffalo, NY
National Provider Identifier
1306802020
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
183345 Issued in NY
Practice address
219 Bryant Street
Buffalo, NY 14222-2006
Phone
(716) 878-7109
Fax
(716) 888-3917
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X 183343 NY
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 183345 NY Primary

Addresses

Primary practice location

219 Bryant Street
Buffalo, NY 14222-2006

Mailing address

4511 Harlem Road
Suite 202
Amherst, NY 14226-3822
Phone (716) 839-6720

Other identifiers 6

IdentifierTypeStateIssuer
3905808OtherIHA
040426001871OtherFIDELIS
000510987001OtherBC/BS
01201110MedicaidNY
00010113401OtherUNIVERA
0010946920003MedicaidPA

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
I20050202000020 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 8527019009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183343NYMDPersonal Emergency Response Attendant
183345NYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health Past Accepting new patients

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1306802020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 HARLEM ROAD",
            "address_2": "SUITE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263822",
            "telephone_number": "716-839-6720",
            "fax_number": "716-839-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 BRYANT STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142222006",
            "telephone_number": "716-878-7109",
            "fax_number": "716-888-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "NY",
            "license": "183343",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "183345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "3905808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426001871",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000510987001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01201110",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010113401",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010946920003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.